A Case of Factitious Hemoptysis

인위성 객혈 1예

  • Kim, Young Il (Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Chonnam National University Medical School) ;
  • Chi, Su Young (Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Chonnam National University Medical School) ;
  • Ban, Hee Jung (Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Chonnam National University Medical School) ;
  • Ju, Jin Yung (Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Chonnam National University Medical School) ;
  • Kwon, Yong Soo (Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Chonnam National University Medical School) ;
  • Oh, In Jae (Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Chonnam National University Medical School) ;
  • Kim, Kyu Sik (Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Chonnam National University Medical School) ;
  • Kim, Yu Il (Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Chonnam National University Medical School) ;
  • Kim, Young Chul (Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Chonnam National University Medical School) ;
  • Lim, Sung Chul (Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Chonnam National University Medical School)
  • 김영일 (전남대학교 의과대학 내과학교실) ;
  • 지수영 (전남대학교 의과대학 내과학교실) ;
  • 반희정 (전남대학교 의과대학 내과학교실) ;
  • 주진영 (전남대학교 의과대학 내과학교실) ;
  • 권용수 (전남대학교 의과대학 내과학교실) ;
  • 오인재 (전남대학교 의과대학 내과학교실) ;
  • 김규식 (전남대학교 의과대학 내과학교실) ;
  • 김유일 (전남대학교 의과대학 내과학교실) ;
  • 김영철 (전남대학교 의과대학 내과학교실) ;
  • 임성철 (전남대학교 의과대학 내과학교실)
  • Received : 2008.08.22
  • Accepted : 2008.10.24
  • Published : 2008.11.30

Abstract

Factitious hemoptysis is the bleeding type of Munchausen's syndrome, and this describes a group of patients who intentionally produce symptoms. Because factitious hemoptysis is a very rare manifestation of hemoptysis, it generally passes unnoticed. We report here on a case of factitious hemoptysis in a 15-year-old boy who presented with hemoptysis. During his three hospitalizations, we conducted many diagnostic procedures, including chest CT, laryngoscopy, bronchoscopy and bronchial arteriography, yet we failed to find the definitive cause of the patient's hemoptysis. He kept on complaining of repetitive hemoptysis and seizure-like activity. His father discovered that he had collected his blood into the specimen cup via an intravenous line. After we removed the intravenous line, he did not show blood to us again. We suggest that factitious hemoptysis should be considered in the differential diagnosis of hemoptysis of an unclear bleeding focus, and especially when the patient has a bizarre hospital course or unusual behavior. We also include a review of the relevant literature.

객혈의 원인은 다양하고, 원인을 찾기 위해 침습적인 검사를 포함하여 여러 검사를 필요로 하는 경우가 있다. 인위성 객혈은 환자가 의도적으로 객혈을 만들어 내는 매우 드문 임상증상으로 간과되기 쉽다. 객혈 원인을 찾기 위한 여러 검사에서 특별한 이상소견이 없을 경우에는 인위성 객혈을 감별 진단해야 한다. 특히 본 증례와 같이 반복적인 객혈 호소와 극단적이고 이상한 임상 양상이나 보기 드문 행동을 하는 경우에는 인위성 객혈을 의심해 보아야 한다.

Keywords

References

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