ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 EP55 | DOI: 10.1530/endoabs.63.EP55

Munchhausen syndrome: in the light of 4 observations

Sara Askaoui, Guizlane Lmghari, Sana Rafi & Nawal El Ansari

Departement of Endocrinology, Marrakech, Morocco.

Definition: Fake hypoglycaemia in children and adults is due to self-administration of insulin or insulin secretagogue. They represent one of the best described facets of the Münchhausen syndrome. Here we report four cases of false hypoglycemia following insulin injection.

Material and method: Prospective study that took place over 2 years to collect 4 hospitalized cases for etiological assessment of severe hypoglycaemia up to 0.2 g/l and complicated convulsive state with coma post-criticism in a case- 3 girls and a teenager, whose age was between 13 and 21 years old. 2 patients are not diabetic while the remaining two are well-followed type 1 diabetics. A hormonal, immunological, morphological assessment was carried out having excluded in the 4 cases the presence of an organic etiology with even the discovery in intra-hospital of a factitious catch of insulin. Psychiatric help was proposed revealing the presence of depression, family conflict, death of a relative, attempted rape.

Discussion: Fake hypoglycaemia is a difficult diagnostic psychiatric disorder. This is most often female patients with easy access to hypoglycemic treatments. Only 50% of diagnosed patients admit the dummy catch after confrontation. Psychiatric follow-up is necessary to avoid recurrences that may be life-threatening in this situation.

Conclusion: Dummy hypoglycaemia, which often remains a diagnosis of elimination, is a serious psychiatric disorder that is difficult to diagnose but needs to be discussed in female patients with easy access to insulin.

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