Chronic factitious disorder with symptoms of AIDS
Article Abstract:
With the increased incidence and public awareness of AIDS, feigned or nongenuine cases of AIDS have also been reported. Feigned AIDS may be associated with various types of psychiatric disorders, including chronic factitious disorder with physical symptoms. This disorder, also known as Munchausen's syndrome, is characterized by the intentional production of physical symptoms in order to be hospitalized, and may be readily associated with AIDS for several reasons. AIDS is characterized by a wide variety of symptoms affecting multiple organ systems, and feigned AIDS may be difficult to detect. Because certain states legally restrict testing for antibodies or immune proteins, which specifically indicate exposure to human immunodeficiency virus (HIV), the diagnosis of AIDS cannot be definitively confirmed. (HIV causes AIDS.) A case is described of a homosexual man who gave a history of diagnoses and symptoms of AIDS, but had no evidence of the disease based on historical, physical examination, and laboratory evidence. His behavior of intentional misrepresentation of diagnoses and physical symptoms and desire to remain in the hospital were suggestive of chronic factitious disorder with physical symptoms. Treatment of AIDS is associated with increased risk of developing adverse effects and places a considerable financial burden on both public and private resources. For example, this patient was previously admitted for overdose with phenobarbital, which was obtained by feigning AIDS. Between 1985 and 1989, he incurred medical expenses greater than $20,000 at one hospital due to five admissions and four emergency room visits. A better knowledge of chronic factitious disorder may help to decrease unnecessary procedures and treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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The chronic fatigue syndrome
Article Abstract:
Chronic fatigue is an often reported symptom in adults. As many as 20 percent of all adults consider themselves significantly fatigued. Only in the past few years has chronic fatigue been considered a possible disease entity in itself. This disease or group of diseases is termed chronic fatigue syndrome (CFS). It is characterized by severe fatigue lasting at least six months and usually following some type of infection. It is predominantly reported in young adults. Chronic fatigue has been reported in various countries for over 100 years, and has often been associated with infectious mononucleosis (IM) and Epstein-Barr virus (EBV) infection. Recent studies have found many patients with CFS were not infected with EBV. The underlying cause of CFS is unknown, but many patients report its onset after a viral infection. Studies on EBV, enteroviruses, and retroviruses do not indicate any of these viruses alone cause CFS, although infection by more than one of these viruses has not been studied as a cause. Immunologic abnormalities are seen in most CFS patients, but no pattern has been found. Some have suggested that psychological factors are the underlying cause of CFS. Depression and immunologic abnormalities have been shown to be related, according to some studies. Treating depression may help CFS sufferers, even if it is more of an effect than a cause. Treatments beyond treating stress for CFS are limited because the cause remains unknown. Long-term studies of the disease have been limited because no clear diagnostic criteria existed until recently. Such studies are needed to help determine the cause and treatments for CFS. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Central diabetes insipidus: a complication of herpes simplex type 2 encephalitis in a patient with AIDS
Article Abstract:
Infection with human immunodeficiency virus (HIV) is often complicated by other infections, including that caused by the herpes simplex virus. A case is described of a 43-year-old HIV-infected man with herpes simplex encephalitis, the inflammation of the brain due to infection with herpes simplex virus type 2. In this patient, herpes simplex encephalitis was complicated by central diabetes insipidus and several nerve-related deficits. Central diabetes insipidus is characterized by inadequate secretion of the antidiuretic hormone (ADH) from the posterior pituitary gland. ADH prevents the elimination of water from the body and contributes to an elevation in blood pressure. A deficiency of ADH results in excessive thirst and urination. The patient had these symptoms along with an abnormal response to dehydration; continued diuresis (loss of body water) resulting in weight loss; low blood levels of ADH; and a slight response to ADH injection. Other symptoms included loss of vision, weakness, severe headache, and confusion. After treatment with the antiviral agent acyclovir, the man recovered cognitive (intellectual) function. Other studies have reported the development of central diabetes insipidus associated with bacterial and viral infections, but this case is the first report of central diabetes insipidus as a complication of AIDS. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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