Severe hypokalemia and hematuria: a case of Munchausen's syndrome.

The term Munchausen syndrome—named after the famed 18th century Baron Munchausen of Germany, whose wide travels and notorious tall tales have inspired literature pieces, several films, and even a popular game— was originally coined in 1951 by Dr. Richard Asher, a British endocrinologist and hematologist who used the term to refer to patients who feign illness.1 Today, most experts use it to describe a rare form of factitious disorder in which patients actively seek to assume the sick role to gain attention, sympathy, and comfort from medical personnel. It is distinguished from malingering because no clear monetary gain, work avoidance, or similar motives are involved. Munchausen syndrome represents an extreme form of factitious disorder, and these patients typically have multiple diagnoses from multiple practitioners they have visited over a prolonged period. Often, they have undergone numerous surgeries and other interventions before being identified and have a high likelihood of previous healthcare employment.