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Munchausen syndrome: a novel cause of drug-resistant hypertension

Pessina, Achille C.a; Bisogni, Valeriaa; Fassina, Ambrogiob; Rossi, Gian Paoloa

doi: 10.1097/HJH.0b013e328360e9ae
ORIGINAL PAPERS: Resistant hypertension

Case report: A young patient presented with a history of resistant arterial hypertension, associated with disabling symptoms. He was subjected to an enormous number of tests to identify a pheochromocytoma that was never found. He was eventually discovered to make factitious use of amphetamine to mimic this condition in order to gain medical attention. Munchausen syndrome was thus diagnosed. The patient was discharged and was lost to follow-up until he presented again in 2012 for ‘resistant hypertension’ in our outpatient clinic. He reported that because of poor blood pressure, he had been referred to a Cardiology department where transcatheter renal denervation was performed with no effect on blood pressure. Thereafter, he was presented to an Endocrinology unit where a left adrenalectomy was performed with diagnosis of pheochromocytoma that was not found at pathology.

Discussion: Munchausen syndrome is a rare psychiatric condition that leads affected patients to cause intentionally signs and symptoms of an illness or injury by inflicting medical harm to their body to attract the attention of the physician and get admission to the hospital.

Conclusion: To our knowledge, this is the first case of causing drug-resistant hypertension and leading to unnecessary renal denervation and adrenalectomy.

aClinica Medica 4

bSurgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy

Correspondence to Gian Paolo Rossi, MD, FACC, FAHA, Department of Medicine (DIMED), Internal Medicine 4 - University Hospital, Via Giustiniani, 2, 35126 Padova, Italy. Tel: +39 049 821 7821/2279; fax: +39 049 821 8783; e-mail:

Abbreviations: ESH, European Society of Hypertension; ESC, European Society of Cardiology; BP, blood pressure; CT, computed tomography; AHA, American Heart Association

Received 4 February, 2013

Revised 20 February, 2013

Accepted 5 March, 2013

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins