Three cases of Munchausen's syndrome mimicking connective tissue diseases

Three young women were admitted to our hospital because of severe anemia and fever of unknown origin. The patients had a long history of frequent hospitalizations and operations. During hospitalization, the patients complained of hematemesis, hematuria and fever, which were sometimes discrepant with their physical and laboratory findings. After the careful observation, the patients were diagnosed as Munchausen syndrome because of either discovery of the tools used to make their symptoms or the patient's confession that these symptoms were made by herself. The patients with Munchausen syndrome sometimes show various symptoms and signs of multisystem inflammatory diseases, which mimic the clinical feature of connective tissue diseases. It is important for rheumatologists to be aware of the existence of Munchausen syndrome among the differential diagnosis of connective tissue diseases.