[Munchausen syndrome by proxy]

Authors report case histories of four siblings with Munchausen syndrome by proxy. The diagnosis was made in the third daughter after six years. Two siblings had died as result of sudden unexplained death at two years old and twelve month old respectively. The mother had typical features outlined in some report. She denied the provocation of any episode and refused further psychiatric help but she accepted medical supervision. A review of the literature: warning signals, plan of action in order to assess the diagnosis and management of this problem are outlined, establishing a discussion about the repercussion of this syndrome.