Corrosive poisoning mimicking cicatricial pemphigoid: Munchausen by proxy

Z Tamay1, A Akcay, G Kilic

  • 1Division of Allergy and Chest Diseases, Department of Pediatrics, Istanbul Medical Faculty, Istanbul, Turkey. eztamay@yahoo.com

Abstract

Insights

Munchausen by proxy (MBP) is a severe form of abuse where a caregiver fabricates illness in a child. This case highlights the fatal consequences of MBP, emphasizing the need for prompt diagnosis.

Area of Science:

  • Medical toxicology
  • Pediatric abuse and neglect
  • Forensic medicine

Background:

  • Munchausen by proxy (MBP) is a severe form of abuse involving fabricated or induced illness in a dependent individual.
  • This abuse, often targeting children or the elderly, can lead to severe health consequences, including death.

Observation:

  • Two siblings were victims of MBP, with one child succumbing to the abuse.
  • Initial misdiagnosis of cicatricial pemphigoid in the first child, who experienced prolonged hospitalizations.
  • The second sibling presented with similar atypical symptoms, leading to the MBP diagnosis.

Findings:

  • The mother administered a household-cleaning product, sodium hydroxide, orally to both children.
  • The investigation revealed repeated administration of a toxic substance as the cause of the children's symptoms.

Implications:

  • Physicians must maintain a high index of suspicion for MBP in cases of unusual or recurrent symptoms in children.
  • Early recognition and intervention are crucial to prevent severe outcomes and fatalities associated with child abuse.

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