Introduction:

Münchhausen syndrome is a subtype of serious and chronic factitious disorder, characterized by the production of pathological lies ("fantastic pseudology") and wandering behavior from doctor to doctor, pretending a physical illness.

Objective:

to present the case of a patient with refractory hypoglycemia secondary to the use of exogenous insulin in the context of a Münchhausen syndrome.

Discussion:

the patient presented an unusual submission to the hospitalizations and to the diagnostic tests, which confirmed the exogenous administration of insulin to trigger the symptoms. The paranoid features and the mythomania observed are associated with a latent, chronic and delirious state, typical of Münchhausen syndrome.

Conclusion:

Münchhausen syndrome is a psychiatric condition that is difficult to diagnose and that constitutes an important challenge for the clinician; it is little recognized, affects the doctor-patient relationship and presents a high cost for the health system due to the use of unnecessary diagnostic and therapeutic procedures. (Acta Med Colomb 2019; 44: 43-46).