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Drug resistant hypertension and Munchausen syndrome
, 2, 3, 1, 1
Affiliations- Department of Hypertension, Angiology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
- Department of Clinical Pharmacology, Poznan University of Medical Sciences, Poznan, Poland
- Department of Rheumatology, Rehabilitation and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
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Abstract
A 40-year-old female presented with a history of resistant arterial hypertension associated with massive nasal bleedings. Despite being subjected to a lot of tests in order to identify a cause of secondary hypertension, all possible causes were excluded. There were no organ damages. Notwithstanding changes in the hypotensive treatment regimen and a significant escalation of pharmacological treatment, there were difficulties in achieving normal blood pressure (BP) values. Resistant hypertension was diagnosed. It was decided to perform tests to confirm the patient’s use of hypotensive drugs and to search for substances increasing BP in the Department of Forensic Medicine. High urinary concentrations of pseudoephedrine and its metabolites were found using high-performance liquid chromatography.
During the retrospective analysis of the case of this patient with a psychiatrist, Munchhausen syndrome was suspected.
Abstract
A 40-year-old female presented with a history of resistant arterial hypertension associated with massive nasal bleedings. Despite being subjected to a lot of tests in order to identify a cause of secondary hypertension, all possible causes were excluded. There were no organ damages. Notwithstanding changes in the hypotensive treatment regimen and a significant escalation of pharmacological treatment, there were difficulties in achieving normal blood pressure (BP) values. Resistant hypertension was diagnosed. It was decided to perform tests to confirm the patient’s use of hypotensive drugs and to search for substances increasing BP in the Department of Forensic Medicine. High urinary concentrations of pseudoephedrine and its metabolites were found using high-performance liquid chromatography.
During the retrospective analysis of the case of this patient with a psychiatrist, Munchhausen syndrome was suspected.
Keywords
resistant hypertension; drug abuse; Munchausen syndrome
About this articleTitle
Drug resistant hypertension and Munchausen syndrome
Journal
Issue
Article type
Case report
Pages
39-44
Published online
2022-03-30
Page views
4566
Article views/downloads
401
DOI
Bibliographic record
Arterial Hypertension 2022;26(1):39-44.
Keywords
resistant hypertension
drug abuse
Munchausen syndrome
Authors
Malgorzata Wierzowiecka
Iwona Smolarek
Karolina Niklas
Andrzej Tykarski
Arkadiusz Niklas
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