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[Induced hypoglycemia. A unusual case of child battering]
Insights
Munchausen syndrome by proxy (MSP) is a form of child abuse where a caregiver fabricates or induces illness in a child. In this case, a mother administered glibenclamide, causing severe hypoglycemia in her 12-year-old child.
Area of Science:
- Pediatrics
- Child Abuse
- Endocrinology
Background:
- Munchausen syndrome by proxy (MSP) is a rare but serious form of child abuse.
- It involves fabricating or inducing illness in a child by a caregiver, often a parent.
- Accurate diagnosis can be challenging, requiring a multidisciplinary approach.
Observation:
- A 12-year-old child presented with recurrent, severe hypoglycemia.
- The child underwent extensive investigations and a subtotal pancreatectomy.
- Maternal administration of glibenclamide was identified as the cause of induced hypoglycemia.
Findings:
- The case highlights the critical role of psychological evaluation in diagnosing MSP.
- Early identification and intervention are crucial for the child's well-being.
- The child's condition resolved after the mother's removal from the child's presence.
Implications:
- This case underscores the importance of considering MSP in unexplained pediatric illnesses, especially those involving recurrent hypoglycemia.
- It emphasizes the need for collaboration between medical professionals, psychologists, and legal authorities in managing such complex cases.
- Protecting the child requires prompt and decisive action, including legal intervention when necessary.
Abstract:
We describe a case of Munchausen's syndrome by proxy in a 12 years old child. The administration of glibenclamide by the mother led to severe hypoglycemias in the child, who underwent various instrumental researches and a subtotal pancreatectomy before the final diagnosis could be reached. The diagnosis also was possible with the substantial help of an accurate psychological survey. The case solution, with disappearance of hypoglycemias, was made possible by the removal of the maternal presence settled by the juvenile court.