Factitious sickle cell acute painful episodes: a secondary type of Munchausen syndrome.

Three adult patients with factitious acute sickle cell painful episodes are presented and the literature is reviewed. The prevalence of this disorder among patients with sickle cell disease in our program was found to be about 0.9%. The patients described to date were all young adults who demonstrated pathological lying (pseudologico fantastico) and most of them had an underlying authentic medical illness to which the feigned signs and symptoms of sickle cell disease were added, thus making the diagnosis more plausible. It is recommended that all patients who present themselves with the signs and symptoms of sickle cell painful episodes be carefully studied in order to confirm the diagnosis.