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Related Experiment Video

Updated: Aug 4, 2025

A Common Marmoset Model of Mother-Infant Intervention for Breastfeeding Disorders in the Presence of Paternal Inhibition and Maternal Neglect
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Munchausen syndrome by proxy: a case report.

Fadiah Alkhattabi1, Israa Bamogaddam2, Afaf Alsagheir2

  • 1Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Al Takhassousi & 12713, Riyadh, 11211, Saudi Arabia. alkhattabifadiah@gmail.com.

Journal of Medical Case Reports
|April 4, 2023
PubMed
Summary

Caregiver-fabricated illness, a dangerous cause of severe hypoglycemia, can be mistaken for persistent hyperinsulinemic hypoglycemia of infancy. High suspicion is crucial for diagnosis and preventing harm.

Keywords:
FabricatedFactitiousHypoglycemiaMunchausen syndromeProxy

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Area of Science:

  • Pediatrics
  • Endocrinology
  • Child Abuse

Background:

  • Persistent hyperinsulinemic hypoglycemia of infancy (PHIHI) is a serious condition caused by excessive insulin secretion.
  • Severe hypoglycemia can stem from other, less obvious causes requiring careful evaluation.

Observation:

  • A case of an 18-month-old Saudi female presenting with recurrent hypoglycemia, initially suspected as PHIHI.
  • Red flags included maternal insistence on pancreatectomy over diagnostic imaging and the timing of hypoglycemic episodes coinciding with maternal presence.

Findings:

  • The patient was diagnosed with caregiver-fabricated illness (also known as Munchausen syndrome by proxy).
  • The diagnosis was made after careful consideration of historical red flags and exclusion of PHIHI.

Implications:

  • Caregiver-fabricated illness is a critical diagnosis that requires a high index of suspicion from healthcare providers.
  • Early recognition and intervention are vital to prevent potentially lethal outcomes for the child.