MUNCHAUSENS-SYNDROME AND THE LABORATORY - SELF-INJECTION OF HUMAN CHORIONIC-GONADOTROPIN

A woman presented to our emergency center after self-injection of huma n chorionic gonadotropin in an attempt to gain admission to the hospit al. Her initial urine pregnancy test (an assay for beta-hCG) was negat ive. Subsequent blood samples received from the patient the same day r evealed markedly elevated beta-hCG levels, suggesting possible laborat ory error. Although the patient's sonogram was negative for an intraut erine pregnancy, an ectopic pregnancy could not be ruled out and the p atient was taken to surgery, where no evidence of pregnancy was found. Retrospective evaluation of the patient's medical history revealed th at she had 30 previous surgical procedures, for which most were perfor med for alleged gynecological reasons. The authors suggest that this c ase of Munchausen's syndrome illustrates one of the more interesting s olutions for a ''laboratory error.''