MUNCHAUSENS-SYNDROME - A CASE PRESENTING AS ASTHMA REQUIRING VENTILATION

We present a variant of Munchausen's syndrome not previously described in which acute severe asthma is the presenting complaint. The clinica l presentation is so extreme that the patient htrs received artificial ventilation on several nl occasions despite having had normal arteria l blood gas values. The patient appears to be able to mimic the signs of severe respiratory distress by means of a protracted Valsalva manoe uvre, and all signs of acute asthma instantaneously disappear with sed ation. Because of the chronic 'asthma', and the frequent dramatic acut e episodes, the patient successfully claims invalidity benefit, and ha s done so for many years.