Malingering can be a difficult diagnosis to discern, especially in patients with well-crafted stories presenting with signs and symptoms that align directly with the literature. This can further become a challenge when a patient is malingering in the setting of a rare disease, where many complaints can be subjective in nature and not entirely testable by physical exam alone. Malingering is responsible for billions of dollars of healthcare waste every single year, and this report can serve as a guide of history elements, signs and symptoms to look out for with patients malingering in the setting of the porphyrias. It is important to recognize when patients are malingering, and when they are not, so that they may receive the appropriate care to help with their condition. This report can also serve as a guideline for what laboratory tests and studies to order in the setting of a suspected porphyria case, in order to confirm the diagnosis and get the patient the appropriate treatment regimen. Intelligent malingering is a growing problem, especially with the amount of access the general public has to medical information, and it is important for us to be able to identify when a patient is truly suffering from a rare disease and when they are malingering.
Rainone GJ, Reznik OE, Majeed M, Popa A. Intelligent Malingering in the Setting of Porphyria Variegata: A Rare Occurrence on Both Fronts. Transformative Medicine (T-Med). 2022; 1(1):24-26. doi: https://doi.org/10.54299/tmed/wbhj8630.