A Case of Factitious Aplastic Anemia

Bright, Robert; Eisendrath, Stuart J.; Damon, Lloyd E.

doi:10.2190/tujb-b2m7-6upv-xplv

Cited by 25 publications

(26 citation statements)

References 12 publications

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“…However, the drug may cause excessive myelosuppression resulting in irreversible marrow aplasia and AA (Reynolds 1993). Factitious AA has also been reported (Ford et al 1984;Bright et al 2001). Peripheral blood in the BU-treated patient may therefore show leucopenia (neutropenia), thrombocytopenia and anaemia.…”

Section: Discussionmentioning

confidence: 91%

Haemotoxicity of busulphan, doxorubicin, cisplatin and cyclophosphamide in the female BALB/c mouse using a brief regimen of drug administration

et al. 2010

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Many anticancer drugs are myelotoxic and cause bone marrow depression; however, generally, the marrow/blood returns to normal after treatment. Nevertheless, after the administration of some anti-neoplastic agents (e.g. busulphan, BU) under conditions as yet undefined, the marrow may begin a return towards normal, but normality may not be achieved, and late-stage/residual marrow injury may be evident. The present studies were conducted to develop a short-term mouse model (a 'screen') to identify late-stage/residual marrow injury using a brief regimen of drug administration. Female BALB/c mice were treated with BU, doxorubicin (DOX), cisplatin (CISPLAT) or cyclophosphamide (CYCLOPHOS) on days 1, 3 and 5. In 'preliminary studies', a maximum tolerated dose (MTD) for each drug was determined for use in 'main studies'. In main studies, mice were treated with vehicle (control), low and high (the MTD) dose levels of each agent. Necropsies were performed, and blood parameters and femoral/humeral nucleated marrow cell counts (FNCC/HNCC) were assessed on six occasions (from days 1 to 60/61 post-dosing). Late-stage/residual changes were apparent in BU-treated mice at day 61 post-dosing: RBC, Hb and haematocrit were reduced, mean cell volume/mean cell haemoglobin were increased and platelet and FNCC counts were decreased. Mice given DOX, CISPLAT and CYCLOPHOS, in general, showed no clear late-stage/residual effects (day 60/61). It was concluded that a brief regimen of drug administration, at an MTD, with assessment at day 60/61 post-dosing was a suitable short-term method/screen in the mouse for detecting late-stage/residual marrow injury for BU, a drug shown to exhibit these effects in man.

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Section: Discussionmentioning

confidence: 91%

Haemotoxicity of busulphan, doxorubicin, cisplatin and cyclophosphamide in the female BALB/c mouse using a brief regimen of drug administration

et al. 2010

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“…She later developed aplastic anemia after covert ingestion of oral busulfan and polymicrobial sepsis possibly secondary to the self‐injection of feces into her central line. The total cost of care for the treatment of this patient's medical complications exceeded $1,100,000 .…”

Section: Discussionmentioning

confidence: 97%

Factitious disorder (Munchausen's syndrome) in oncology: case report and literature review

et al. 2015

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Background Factitious disorder is where patients repeatedly seek medical care for feigned illnesses in the absence of obvious external rewards; ‘Munchausen’s syndrome’ is the historical name for this disorder. Method We report on a case that was presented to a tertiary oncology center as a suspected rare bone cancer. Results and Conclusions Psychosocial clinicians working in oncology settings should be aware of the complexities of diagnosing factitious disorder in cancer settings where empathy is prominent and suspicion unusual. Moreover, comorbidity can cloud the diagnosis (in this case substance abuse), and, even when accurately diagnosed, there are no evidence-based management approaches to offer to the patient. What seems to linger most after the patient is discharged, usually in a huff, are strong counter-transference feelings and substantial medical bills.

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“…Early detection of FD is in order to limit wastage of healthcare resources and harm to patients [6,7].…”

Section: With Predominant Physical Signs and Symptomsmentioning

confidence: 99%

A Systematic Review on Factitious Disorders: Psychopathology and Diagnostic Classification

Caselli¹,

Poloni²,

Ceccon³

et al. 2018

Neuropsychiatry

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Factitious disorder (FD) is a psychiatric disorder in which sufferers intentionally fabricate physical or psychological symptoms in order to assume the role of the patient, without any obvious gain. The clinical and demographic profile of patients with FD has not been sufficiently clarified. The aims of this study are: to outline a demographic and clinical profile of a large sample of patients with FD, to highlight the psychopathological correlates and to study the evolution of position of FD in the DSM. A systematic search for all case reports and case series of adult patients in the databases MEDLINE, Scopus and PsycINFO was conducted. 1636 records were obtained based on key search terms, after exclusion of duplicate records. 577 articles were identified as potentially eligible for the study, of which 314 studies were retrieved for full-text review. These studies included 514 cases. Variables extracted included age, gender, reported occupation, comorbid psychopathology, clinical presentation and factors leading to the diagnosis of FD. 64.5% of patients in the sample were females. Mean age at presentation was 33.5 y.o. A healthcare profession was reported most frequently (n=113). Patients were most likely to present in psychiatry, neurology, emergency and internal medicine departments. Statistical analysis has highlighted significant correlations between factitious disorders and depressive disorders and borderline personality disorder (BPD) and a significant effect of BPD and abuses in childhood on substance abuse. The survey of socio-demographic profile of the sample has highlighted some important points for early diagnosis and early psychiatric treatment. The research also allows deepening the psychopathological correlates of the disorder. The study showed that patients did not meet DSM-5 diagnostic criteria in the 11.3% of cases.

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A Case of Factitious Aplastic Anemia

Cited by 25 publications

References 12 publications

Haemotoxicity of busulphan, doxorubicin, cisplatin and cyclophosphamide in the female BALB/c mouse using a brief regimen of drug administration

Haemotoxicity of busulphan, doxorubicin, cisplatin and cyclophosphamide in the female BALB/c mouse using a brief regimen of drug administration

Factitious disorder (Munchausen's syndrome) in oncology: case report and literature review

A Systematic Review on Factitious Disorders: Psychopathology and Diagnostic Classification

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