2021, Number 4
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Rev Mex Pediatr 2021; 88 (4)
Recurrent severe hypoglycemia secondary to factitious disorder by proxy
Osorio-Acuña LC, Angulo-Mosquera M, Salazar-Solarte AM, Aristizabal-Henao C, Torres-Canchala L, Gómez-Castro JF
Language: Spanish
References: 15
Page: 152-155
PDF size: 173.42 Kb.
ABSTRACT
Objective: To describe a pediatric patient with factitious disorder by proxy or Münchausen syndrome.
Case description: A two-year-old female patient with a history of a sister who died, but who also had repeated hypoglycemia. Before the most recent admission, the patient had been hospitalized for hypoglycemia on several occasions. On this last occasion, she presented with asthenia and syncope, documenting a blood glucose level of 22 mg / dL. All laboratory studies to determine the cause of hypoglycemia were normal. Through psychiatric intervention, the mother confessed that she administered insulin to the patient exogenously.
Conclusion: Factitious disorder by proxy is a serious form of child abuse, where the caregiver performs actions to generate morbidity. Its early identification will prevent its perpetuation and a possible fatal outcome.
REFERENCES
Gruppuso PA, Schwartz R. Hypoglycemia in children. Pediatr Rev. 1989; 11(4): 117-124. doi: 10.1542/pir.11-4-117.
Hoe FM. Hypoglycemia in infants and children. Adv Pediatr. 2008; 55: 367-384. doi: 10.1016/j.yapd.2008.07.008.
Yates G, Bass C. The perpetrators of medical child abuse (Munchausen Syndrome by Proxy) - A systematic review of 796 cases. Child Abuse Negl. 2017; 72: 45-53. doi: 10.1016/j.chiabu.2017.07.008.
Umpierrez G, Korytkowski M. Diabetic emergencies - ketoacidosis, hyperglycaemic hyperosmolar state and hypoglycaemia. Nat Rev Endocrinol. 2016; 12(4): 222-232. doi: 10.1038/nrendo.2016.15.
Hall DE, Eubanks L, Meyyazhagan LS, Kenney RD, Johnson SC. Evaluation of covert video surveillance in the diagnosis of munchausen syndrome by proxy: lessons from 41 cases. Pediatrics. 2000; 105(6): 1305-1312. doi: 10.1542/peds.105.6.1305.
Noeker M, Franke I. Structured interviewing of children in suspected child endangerment cases: the German version of the revised NICHD investigative interview protocol. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2018; 61(12): 1587-1602. doi: 10.1007/s00103-018-2838-4.
Tatu L, Aybek S, Bogousslavsky J. Munchausen syndrome and the wide spectrum of factitious disorders. Front Neurol Neurosci. 2018; 42: 81-86. doi: 10.1159/000475682.
Sousa Filho D, Kanomata EY, Feldman RJ, Maluf Neto A. Munchausen syndrome and Munchausen syndrome by proxy: a narrative review. Einstein (Sao Paulo). 2017; 15(4): 516-521. doi: 10.1590/S1679-45082017MD3746.
Swonke ML, Smith SA, Ohlstein JF, Siddiqui F, Szeremeta W, Pine HS. Unexplained destructive nasal lesions in half-brothers: a possible case of Munchausen syndrome by proxy. Int J Pediatr Otorhinolaryngol. 2019; 123: 75-78. doi: 10.1016/j.ijporl.2019.04.029.
Nathanson M. Münchausen syndrome by proxy. Child Abus Diagnostic Forensic Considerations. 2018; (26): 303-312. doi: 10.1007/978-3-319-65882-7_16.
Culotta PA, Isaac R, Sarpong K, Chandy B, Cruz A, Donaruma-Kwoh M. Nasal erosion as an uncommon sign of child abuse. Int J Pediatr Otorhinolaryngol. 2018; 108: 95-99. doi: 10.1016/j.ijporl.2018.02.024.
Schreier HA, Libow JA. Munchausen by proxy syndrome: a modern pediatric challenge. J Pediatr. 1994; 125(6 Pt 2): S110-S115. doi: 10.1016/s0022-3476(05)82934-8.
Grunwaldt LJ, Adetayo OA, MacIsaac ZM, Losee JE, Kumar AR. Successful reconstruction of complex pediatric nasal lesions: improving outcomes using dermal regenerative templates. Plast Reconstr Surg Glob Open. 2014; 2(2): e107. doi: 10.1097/GOX.0000000000000033.
Tozzo P, Picozzi M, Caenazzo L. Munchausen syndrome by proxy: balancing ethical and clinical challenges for healthcare professionals ethical consideration in factitious disorders. Clin Ter. 2018; 169(3): e129-e134. doi: 10.7417/T.2018.2067.
Kelly M, Bursch B. Factitious disorder imposed on another. In: Driver D, Thomas S. Complex Disord Pediatr Psychiatry. A Clinician´s Guide. Elsevier Inc. 2018. pp. 105-115. https://doi.org/10.1016/B978-0-323-51147-6.00009-0.