Differential diagnostics of hypoglycemia as a symptom of "Munchausen syndrome": a clinical case

In this study we are presenting a case of feigned illness in a woman. Women with Munchausen syndrome tend to have a stable social status; they often have access to health care professionals or to medical literature. Intentionally induced hypoglycaemia is a particular kind of simulated illness, as it can result in a life-threatening coma. Given its dangers, the doctor will look for causes of hypoglycaemia in an attempt to identify appropriate treatment. A diagnosis of feigned illness can only be established by excluding a wide variety of conditions that involve hypoglycaemia. Legal and ethical norms pose serious obstacles to finding proof that hypoglycaemia has been induced artificially and does not result from any concurrent illness.