The Turkish Journal of Pediatrics
2013 , Vol 55 , Num 3
Munchausen Syndrome by Proxy Presented as Recurrent Respiratory Arrest and Thigh Abscess: A Case Study and Overview
Departments of 1Child and Adolescent Psychiatry, 2Pediatrics, 3Psychiatry, and 4Forensic Medicine, Hacettepe University
Faculty of Medicine, Ankara, Turkey. E-mail: dilsad_ozdemir@yahoo.com
While many physicians are familiar with the sexual or physical abuse of
children, there is little awareness about Munchausen syndrome by proxy
(MSBP). As case reports of MSBP increase, awareness among physicians is
thought to increase as well. We thus present herein a 16-month-old girl who
admitted to Hacettepe University İhsan Doğramacı Children’s Hospital with
the complaint of seizure, recurrent apnea and thigh abscess, who was later
diagnosed as MSBP. The case was being followed by the Child Protection
Team of the hospital (Haceteppe University Child Protection Unit [HU-CPU]).
HU-CPU contributed to the early detection of this case and protected the
child from a possible fatal outcome. The mother was confronted for MSBP
and refused to take responsibility for her child’s symptoms. As seen in this
case, when MSBP is suspected, psychiatric evaluation of the mother, evaluation
of the mother-child interaction and collection of a detailed family and social
history can have a positive impact on the prognosis in these cases. This case
report underlines the importance of multidisciplinary team work to share the
responsibility and reduce the burden during the treatment process of these
difficult and complicated cases.
Keywords :
Munchausen syndrome by proxy, child abuse, psychopathology,
multidisciplinary team.