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[Urinary calculi and Munchausen syndrome]
G Absolut de la Gastine1, M J Penniello, M Le Treust
1Service de pédiatrie B, hôpital Clemenceau, Caen, France.
Summary
Munchausen syndrome, a rare pediatric condition, was diagnosed in an 8.5-year-old boy presenting with urinary stones. The boy confessed to inserting pebbles into his urinary tract, revealing underlying psychological distress.
Area of Science:
- Pediatric Psychology
- Medical Case Reports
- Factitious Disorder
Background:
- Munchausen syndrome is infrequently documented in pediatric literature.
- It is distinct from Munchausen syndrome by proxy, a form of child abuse.
- This case highlights the rarity of self-induced medical conditions in children.
Observation:
- An 8.5-year-old boy presented with recurrent urinary stones and atypical symptoms.
- Initial investigations including ultrasonography were normal; however, imaging revealed transient urethral abnormalities.
- The child passed numerous stones without significant pain, raising clinical suspicion.
Findings:
- Diagnosis of Munchausen syndrome was confirmed by chemical analysis of the "stones" (revealed as pebbles) and the child's confession.
- The discrepancy between stone passage and absence of typical renal colic or hematuria was key.
- The child admitted to self-inserting pebbles into his urinary tract.
Implications:
- Unusual pediatric presentations may indicate factitious disorders like Munchausen syndrome.
- This syndrome can serve as a critical indicator of underlying psychological distress in children.
- Early recognition is vital for appropriate psychological intervention and management.