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[Factitious lithiasis: Case report from Western Algeria].

A 19-year-old woman with recurrent lithiasis was admitted to the urology department for renal colic. Although radiologic examinations and laboratory tests were negative, the patient regularly brought into consultations small "stones", resembling gravel, that she said had been spontaneously expelled. These 42 samples were the object of a preliminary morphological analysis under a binocular magnifier to detect their particulate components. A non-metabolic origin was suspected from the organoleptic characteristics of their surfaces and sections. In view of the diversity of the materials of these apparently false calculi, methods of precise physical analysis were necessary to ascertain their exact origin and thereby confirm the diagnosis of factitious lithiasis. The use of two methods of physical analysis, infrared spectrophotometry and x-ray diffraction, enabled us to determine their exact chemical and mineralogical composition. The samples claimed to be of urinary origin actually consisted of exogenous products of various compositions. Some samples were made of pure calcite, others of mixed calcite and silicates. Moreover several samples of the patient's first morning urine showed no correlation between the nature of the crystalluria and the composition of these stones. These tests made it possible to direct the clinician towards useful complementary investigations. This strange case represents 0.1% of the urinary calculi analysed in Western Algeria.

Adult↗
PubMed2006

A case of factitious subcutaneous emphysema.

A 13-year-old girl presented with a 2-month history of recurrent soft tissue swelling of her right upper extremity. Dermatological examination revealed soft tissue crepitation and a small ulcer on the dorsum of her right hand. After several investigations including radiographic and systemic blood tests the diagnosis of factitious subcutaneous emphysema was made and the patient was referred to psychiatry for proper management.

Adolescent↗
PubMed1991

An unusual case of factitious arthritis.

Factitious arthritis is an unusual manifestation of a factitious illness. We report a case of factitious arthritis after the self insertion of needles and fragments of metallic paper clips into the knee joint area. The case illustrates an unusual presentation of Munchausen's syndrome.

Adult↗
PubMed1991

[Spontaneous seizures improve severe dementia conditions. Dementia contra depression-induced pseudodementia and electric stimulation therapy of depressed patients with epilepsy].

On the basis of two case reports, the differential diagnostic difficulties between pseudodementia conditioned by depression and genuine dementia are discussed and the particular conditions present in connection with electroconvulsive therapy (ECT) in patients with reduced seizure thresholds. Differentiation between genuine and dementia conditioned by depression must be made mainly on the basis of the clinical picture, particularly the temporal course of the condition. Every condition of dementia involves the possibility of an underlying depression and antidepressive treatment should be offered on wide indications. In this connection, ECT treatment may be the most effective and mildest form of therapy. Epilepsy does not counterindicate ECT treatment which, on the other hand, has an anticonvulsive effect. Occurrence of spontaneous seizures in connection with ECT treatment does not necessarily indicate withdrawal of treatment which may be continued provided certain prerequisites are observed.

Aged↗
PubMed1991

Localization of self-inflicted dermatological lesions: what do they tell the dermatologist?

The dissimulating attitude of factitious patients creates the need for objective clinical features which cannot be faked and which have a genuine value for the psychiatric diagnosis and prognosis. The psychiatric significance of the localization of self-inflicted dermatological lesions is investigated in four psychiatric areas: the type of life events preceding specific localizations, underlying psychiatric profiles that are characteristic for a given localization, differential response to treatment and psychiatric sequels.

Adult↗