Munchausen's syndrome and the laboratory. Self-injection of human chorionic gonadotropin.

Abstract

A woman presented to our emergency center after self-injection of human chorionic gonadotropin in an attempt to gain admission to the hospital. Her initial urine pregnancy test (an assay for beta-hCG) was negative. Subsequent blood samples received from the patient the same day revealed markedly elevated beta-hCG levels, suggesting possible laboratory error. Although the patient's sonogram was negative for an intrauterine pregnancy, an ectopic pregnancy could not be ruled out and the patient was taken to surgery, where no evidence of pregnancy was found. Retrospective evaluation of the patient's medical history revealed that she had 30 previous surgical procedures, for which most were performed for alleged gynecological reasons. The authors suggest that this case of Munchausen's syndrome illustrates one of the more interesting solutions for a "laboratory error."