Munchausen Syndrome by Proxy – A Rare but Real Type of Abuse
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.25754/pjp.2021.20072 |
Resumo: | Munchausen by proxy is a rare form of abuse that presents a significant risk of morbidity and mortality for the child, with the mother being responsible for the vast majority of cases. We describe the clinical case of a 2-year-old boy admitted by fever, vomits, diarrhoea and refusal to feed. During hospitalization he started vomiting with blood and was treated accordingly. On the night of the planned discharge he started with sleepiness, petechiae dispersed throughout the trunk and gross haematuria, and a thorough etiological investigation was done. Later on, he had another episode of sudden and transient miosis, sweating, absence of reactivity and haemolysis with alterations of the coagulation tests - Munchausen syndrome by proxy was suspected. Samples of blood, urine, vomit and food found near the child's bed were then collected and sent to analysis. The results of the samples, revealed toxic levels of isopropanol – a product normally used for hand desinfection. During the hospitalization, it was discovered that the mother had a past history of mental disease. Isopropanol intoxication is relatively frequent because of its easy accessibility. Symptoms involve the gastrointestinal tract, the central nervous system (CNS), and the cardiovascular system at higher doses. It is important to reinforce the idea of considering the suspicion of Munchausen syndrome due to the presence of children with supposed symptoms that do not allow to consolidate a clear clinical diagnosis, the lack of response to the treatments implemented and the repeated demand for assistance in different health institutions. |
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Munchausen Syndrome by Proxy – A Rare but Real Type of AbuseCase reportsMunchausen by proxy is a rare form of abuse that presents a significant risk of morbidity and mortality for the child, with the mother being responsible for the vast majority of cases. We describe the clinical case of a 2-year-old boy admitted by fever, vomits, diarrhoea and refusal to feed. During hospitalization he started vomiting with blood and was treated accordingly. On the night of the planned discharge he started with sleepiness, petechiae dispersed throughout the trunk and gross haematuria, and a thorough etiological investigation was done. Later on, he had another episode of sudden and transient miosis, sweating, absence of reactivity and haemolysis with alterations of the coagulation tests - Munchausen syndrome by proxy was suspected. Samples of blood, urine, vomit and food found near the child's bed were then collected and sent to analysis. The results of the samples, revealed toxic levels of isopropanol – a product normally used for hand desinfection. During the hospitalization, it was discovered that the mother had a past history of mental disease. Isopropanol intoxication is relatively frequent because of its easy accessibility. Symptoms involve the gastrointestinal tract, the central nervous system (CNS), and the cardiovascular system at higher doses. It is important to reinforce the idea of considering the suspicion of Munchausen syndrome due to the presence of children with supposed symptoms that do not allow to consolidate a clear clinical diagnosis, the lack of response to the treatments implemented and the repeated demand for assistance in different health institutions.Sociedade Portuguesa de Pediatria2021-07-16info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.25754/pjp.2021.20072eng2184-44532184-3333Canelas, Marta Ezequiel FragaEscobar, CarlosNunes, PedroLoureiro, Helena CristinaTorre, Maria LurdesAlmeida, Helena Isabelinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-08-03T02:58:09Zoai:ojs.revistas.rcaap.pt:article/20072Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:25:35.000801Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Munchausen Syndrome by Proxy – A Rare but Real Type of Abuse |
title |
Munchausen Syndrome by Proxy – A Rare but Real Type of Abuse |
spellingShingle |
Munchausen Syndrome by Proxy – A Rare but Real Type of Abuse Canelas, Marta Ezequiel Fraga Case reports |
title_short |
Munchausen Syndrome by Proxy – A Rare but Real Type of Abuse |
title_full |
Munchausen Syndrome by Proxy – A Rare but Real Type of Abuse |
title_fullStr |
Munchausen Syndrome by Proxy – A Rare but Real Type of Abuse |
title_full_unstemmed |
Munchausen Syndrome by Proxy – A Rare but Real Type of Abuse |
title_sort |
Munchausen Syndrome by Proxy – A Rare but Real Type of Abuse |
author |
Canelas, Marta Ezequiel Fraga |
author_facet |
Canelas, Marta Ezequiel Fraga Escobar, Carlos Nunes, Pedro Loureiro, Helena Cristina Torre, Maria Lurdes Almeida, Helena Isabel |
author_role |
author |
author2 |
Escobar, Carlos Nunes, Pedro Loureiro, Helena Cristina Torre, Maria Lurdes Almeida, Helena Isabel |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Canelas, Marta Ezequiel Fraga Escobar, Carlos Nunes, Pedro Loureiro, Helena Cristina Torre, Maria Lurdes Almeida, Helena Isabel |
dc.subject.por.fl_str_mv |
Case reports |
topic |
Case reports |
description |
Munchausen by proxy is a rare form of abuse that presents a significant risk of morbidity and mortality for the child, with the mother being responsible for the vast majority of cases. We describe the clinical case of a 2-year-old boy admitted by fever, vomits, diarrhoea and refusal to feed. During hospitalization he started vomiting with blood and was treated accordingly. On the night of the planned discharge he started with sleepiness, petechiae dispersed throughout the trunk and gross haematuria, and a thorough etiological investigation was done. Later on, he had another episode of sudden and transient miosis, sweating, absence of reactivity and haemolysis with alterations of the coagulation tests - Munchausen syndrome by proxy was suspected. Samples of blood, urine, vomit and food found near the child's bed were then collected and sent to analysis. The results of the samples, revealed toxic levels of isopropanol – a product normally used for hand desinfection. During the hospitalization, it was discovered that the mother had a past history of mental disease. Isopropanol intoxication is relatively frequent because of its easy accessibility. Symptoms involve the gastrointestinal tract, the central nervous system (CNS), and the cardiovascular system at higher doses. It is important to reinforce the idea of considering the suspicion of Munchausen syndrome due to the presence of children with supposed symptoms that do not allow to consolidate a clear clinical diagnosis, the lack of response to the treatments implemented and the repeated demand for assistance in different health institutions. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-07-16 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.25754/pjp.2021.20072 |
url |
https://doi.org/10.25754/pjp.2021.20072 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
2184-4453 2184-3333 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Pediatria |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Pediatria |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799133524842774529 |