Factitious disorder, a rare psychological disorder characterized by falsification of medical conditions for attention, was discovered in a woman who posed as a patient with acute intermittent porphyria. Upon initial examination, the woman had described symptoms of abdominal pain and jerking movements in her right arm and leg, which are consistent with porphyria. However, she was not responding to standard porphyria treatment and her urinary PBG and porphyrin levels were normal. When doctors considered other diagnoses such as bowel obstruction, biliary colic, appendicitis, or pancreatitis, nothing quite fit. More oddities surfaced as the doctors realized they could not confirm the woman’s identity, yet they were being contacted by other hospitals inquiring about female patients with similar histories of acute intermittent porphyria. Ultimately, the doctors concluded that the woman had factitious disorder, a diagnosis that poses a poor prognosis due to the risks associated with unnecessary medical or surgical interventions.
