Factitious Hematuria in Two Teenage Boys

Abstract

Children's physicians rarely think of make-believe illness when presented with a complaint of bloody urine. Factitious illness—defined here as self-inflicted injury or deliberate alteration of clinical or laboratory observations, by parent or child—is identified in 1% of children referred to us for pediatric rheumatology evaluation. Although more than half of all of these youngsters pretend to have fever, two have had gross hematuria as the major objective sign of disease. Report of Cases. —Case1.—A 17-year-old boy was admitted to the Babies Hospital, New York, in October 1972 because of hematuria. He was said to have been well until 11 years of age, when he had an acute febrile illness associated with a polymorphous rash, cervical lymphadenopathy, dry, cracked lips, conjunctival telangiectasia, jaundice, and peeling of the fingertips during recovery, which in retrospect may have been Kawasaki's disease. He was hospitalized for more than two weeks and lost 11.3