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Real or Contrived?

Sumner Marshall, MD

JAMA. 1981;245(15):1557.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

WHEN a patient appears in the emergency room with flank pain, bloody urine, and a history of allergy to intravenous pyelogram (IVP) dye, the physician should be aware of the strong possibility of contrived illness.

We have encountered many such patients over the years. However, since every time these patients appear their stories and clinical findings seem so convincing to the hosptal staff, we believe the characteristics that make up this "profile" are worth describing. The following case illustrates many of these characteristics.

Report of a Case

A man in his mid-20s arrived unaccompanied in the emergency room of a Berkeley, Calif, hospital on a Saturday at 2 AM, complaining of severe abdominal and flank pain with grossly bloody urine. He had no identification with him. He stated that, because of a previous severe allergic reaction after ingestion of shellfish, he had been strongly advised never to permit the intravenous . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Urology, University of California School of Medicine, San Francisco.

Footnotes
Reprint requests to Urology, M-553, University of California, San Francisco, CA 94143 (Dr Marshall).

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