# Hymenoptera Venom Immunotherapy Meets Factitious Disorder

## TL;DR

A young woman faked severe allergic reactions during venom immunotherapy, leading to a diagnosis of factitious disorder.

## Contribution

Reports a rare case of factitious anaphylaxis during hymenoptera venom immunotherapy.

## Key findings

- Patient exhibited symptoms like stridor and loss of consciousness during venom immunotherapy.
- Diagnosis of factitious disorder led to discontinuation of treatment.
- Highlights the importance of considering psychiatric factors in allergy treatment.

## Abstract

Factitious disorder on self is a psychiatric disorder in which individuals fabricate or induce signs or symptoms of a disease. Factitious anaphylaxis, with symptoms suggestive of a life-threatening allergic reaction, is extremely rare. Several cases of factitious disorder reactions during allergen immunotherapy for airborne allergens have been reported. We report the case of a young female patient who presented factitious anaphylaxis during venom immunotherapy to vespid venom extract. Symptoms of stridor, dyspnea, coughing and loss of consciousness were observed during the built-up phase of venom immunotherapy, mimicking allergic reactions to the venom extracts. Diagnosis of factitious disorder prompted the discontinuation of venom immunotherapy.