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Related Experiment Videos

Surreptitious warfarin ingestion.

S T White, K Voter, J Perry

    Child Abuse & Neglect
    |January 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    This case report details a rare instance of Munchausen by proxy where a mother used anticoagulant medication to harm her child, leading to a hemorrhagic disorder. This highlights a critical form of child abuse that requires careful medical consideration.

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    Area of Science:

    • Pediatrics
    • Toxicology
    • Child Psychiatry

    Background:

    • Munchausen by proxy (MBP) involves inducing or fabricating illness in a child.
    • Covert anticoagulant ingestion is a known form of adult self-harm or abuse.
    • This case presents a unique overlap of these conditions in a pediatric patient.

    Purpose of the Study:

    • To report a novel case combining features of Munchausen by proxy and covert anticoagulant ingestion in an infant.
    • To emphasize the diagnostic challenges and considerations for this rare form of child abuse.
    • To highlight the importance of considering induced hemorrhagic disorders in pediatric differentials.

    Main Methods:

    • Case report of an 11-month-old female presenting with hemorrhagic otitis media and subcutaneous nodules.

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  • Diagnostic workup included coagulation studies and serum warfarin level.
  • Psychiatric evaluation of the mother revealed characteristics of MBP and anticoagulant malingering.

    • Main Results:

    • Coagulation studies indicated Vitamin K deficiency consistent with anticoagulant ingestion.
    • Serum warfarin levels confirmed the presence of the anticoagulant.
    • The mother exhibited psychological traits associated with Munchausen by proxy and anticoagulant abuse.

    Conclusions:

    • This case illustrates the dangerous combination of Munchausen by proxy and anticoagulant poisoning in a child.
    • Healthcare providers should consider induced hemorrhagic disorders in the differential diagnosis of unexplained bleeding in children.
    • Prompt psychiatric intervention for the perpetrator and protective placement for the child are crucial.