The Case of the Famous Woman With a Bloated Belly

Albert B. Lowenfels, MD

Disclosures

January 11, 2010

Introduction

The patient was a wealthy, 39-year-old woman who developed abdominal swelling, amenorrhea, engorgement of the breasts, and galactorrhea after she had been married for a few months. The initial symptoms and abdominal swelling persisted for many months, causing the patient and her physicians to believe that she was pregnant. During this time she was surrounded by her husband, family, and friends who all fervently wished for the birth of a normal, healthy child -- preferably a male child. However, to the disappointment and dismay of the patient, her husband, and the entire country, the patient never went into labor, nor did she ever produce a baby. Because of her social status and rank, a physical examination was deemed inappropriate and was never performed. No tests were performed, particularly a pregnancy test.

Medical and Family History

Family History

The patient's mother was short, overweight, and had 6 pregnancies, including several stillborn births. Of these pregnancies, only the patient survived to become an adult. Her mother was divorced from the patient's father and died of unknown causes at age 51.

The patient's father was married several times. In later life he suffered from obesity, frequent boils, and incapacitating leg ulcers. He died at age 56.

The patient had 1 healthy, younger half sister who lived to adulthood and a younger half brother who died at age 16.

Personal and Medical History

The patient was an esteemed member of the ruling class. She did not smoke and her alcohol consumption was minimal.

She was thin, had suffered from frequent bouts of indigestion, and had lost numerous teeth. The patient also had severe headaches and episodes of depression. She had previously complained of irregular menses and amenorrhea.

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