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Factitious diabetes mellitus confirmed by ascorbic acid.

J H Nading, B Duval-Arnould

    Archives of Disease in Childhood
    |February 1, 1984
    PubMed
    Summary
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    A mother falsified her child's diabetes mellitus symptoms, but hospital evaluation and ascorbic acid testing revealed urine substitution. This case highlights the importance of thorough diagnostic evaluation to rule out fabricated medical conditions.

    Area of Science:

    • Pediatric Endocrinology
    • Clinical Diagnostics
    • Medical Ethics

    Background:

    • Diabetes mellitus is a common endocrine disorder in children.
    • Accurate diagnosis is crucial for appropriate management and preventing complications.
    • Falsification of medical conditions, known as factitious disorder imposed on another, presents diagnostic challenges.

    Observation:

    • A 3.5-year-old girl presented with signs and symptoms suggestive of diabetes mellitus.
    • Initial hospital evaluation rapidly excluded a diagnosis of diabetes mellitus.
    • The patient's mother was suspected of fabricating the illness.

    Findings:

    • Ascorbic acid was utilized as a marker to detect urine substitution.
    • Laboratory analysis confirmed that the urine samples were substituted, indicating maternal fabrication.

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  • The child was not suffering from diabetes mellitus.

    • Implications:

    • This case underscores the critical need for comprehensive diagnostic workups in pediatric cases, especially when symptoms are inconsistent or suspicious.
    • Healthcare providers must be vigilant for potential medical child abuse or factitious disorder imposed on another.
    • Utilizing specific markers like ascorbic acid can be instrumental in uncovering urine substitution and confirming fabricated illnesses.