Munchausen syndrome by proxy: a case report

Abstract

Background Inappropriately high levels of insulin secretion can cause the potentially fatal condition of persistent hyperinsulinemic hypoglycemia of infancy. Our paper focuses on another cause of severe hypoglycemia, which can be easily missed. Case presentation An 18-month-old Saudi female was referred to our hospital for further investigation and management of her recurrent hypoglycemic attacks as a case of persistent hyperinsulinemic hypoglycemia of infancy. During admission, we noticed multiple red flags from the history; the mother was insisting on a pancreatectomy, rather than going for a positron emission tomography scan, and most importantly, all hypoglycemic attacks occurred while the mother was around. Consequently, after further investigation, the case was diagnosed as a caregiver-fabricated illness, and the case was referred to the Child Protection Center. Conclusions One must have a high index of suspicion to diagnose caregiver-fabricated illness. Physicians should be more attentive to prevent such a disease, which could eventually become lethal if left unnoticed.

Munchausen Syndrome by Proxy Presenting as Pharyngeal Dysphagia and Recurrent Mouth Ulcers: A Case Report

“…A few other cases regarding MSBP in Saudi Arabia were reported, including a report by Al-Mugeiren and Ganelin about a 17-month-old Saudi male who presented with recurrent episodes of hematemesis, bleeding per rectum, and hematuria [ 10 ]. In addition, Alkhattabi et al reported a case of factitious hypoglycemia [ 11 ]. Overall, these case reports collectively underscore the presence of MSBP in Saudi Arabia and provide valuable clinical insights.…”

Hidden harm

“…2 FDIA is a psychiatric disease in which the caregiver induces symptoms of illness or harm in someone under their care, or attention from the treatment. 3,4 A person with FDIA may earn praise from others for their devotion to the dependent who's frequently hospitalized, and the dependent provides a way for the person with FDIA to develop relationships with physicians or other healthcare providers. In this way, the person gains attention from others by appearing to be a loving and compassionate caregiver of the dependent under their care.…”

“…In this way, the person gains attention from others by appearing to be a loving and compassionate caregiver of the dependent under their care. 3,4 This disease is complex, misunderstood, and has severe consequences for the person who is abused, commonly individuals from vulnerable populations, such as children and older adults. 1 Consequences include negative impacts on the health and well-being of the targeted individuals, leading to physical and mental damage and sometimes death.…”