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Albuminuric growth failure. A case of Munchausen syndrome by proxy

E G Lyall1, H F Stirling, P M Crofton

  • 1Royal Hospital for Sick Children, Edinburgh, UK.

Acta Paediatrica (Oslo, Norway : 1992)
|April 1, 1992
PubMed

Insights

Munchausen syndrome by proxy was diagnosed in a child with growth failure due to the detection of foreign substances in her urine. The child

Area of Science:

  • Pediatric Medicine
  • Toxicology
  • Child Abuse and Neglect

Background:

  • Munchausen syndrome by proxy (MSP) is a rare form of child abuse where a caregiver fabricates or induces illness in a child.
  • Early recognition and diagnosis are crucial for the child's well-being and to prevent further harm.

Observation:

  • A five-year-old girl presented with severe failure to thrive, lethargy, vomiting, and metabolic acidosis.
  • Urine analysis revealed the presence of egg albumin, diphenhydramine, and phenothiazine metabolites, inconsistent with natural physiological processes.

Findings:

  • The diagnostic findings led to a confirmed diagnosis of Munchausen syndrome by proxy.
  • Following the diagnosis and intervention, the child's growth and overall condition significantly improved.

Implications:

  • This case highlights the importance of considering fabricated or induced illnesses in pediatric differential diagnoses, especially with unexplained symptoms.
  • The subsequent death of another child in the family from sudden infant death syndrome underscores the potential severity and tragic outcomes associated with undiagnosed or untreated MSP.
  • Healthcare professionals must be vigilant for signs of child abuse, including MSP, to ensure timely intervention and protect vulnerable children.

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