Milroy C M
Department of Forensic Pathology, University of Sheffield, The Medico-Legal Centre, Watery Street, Sheffield, S3 7ES, UK.
Int J Legal Med. 1999;112(5):309-12. doi: 10.1007/s004140050255.
Munchausen syndrome by proxy is characterised by the invention of a false history and/or the deliberate inducement of a factitious illness by parents in their child. First reported as a disorder of mothers, this syndrome is now recognised to have male perpetrators. One of the most common characteristic presentations is with the child allegedly suffering repeated apnoeic attacks. These are in fact deliberately induced episodes of upper airway obstruction. The children of these parents are at great risk of serious harm or death if not recognised. The identification of smothering at autopsy is fraught with difficulty and the presence of intra-alveolar haemosiderin has been claimed to be a marker of previous smothering. A case of Munchausen syndrome by proxy is presented where there were deliberate acts of repeated partial smothering and where the finding of intra-alveolar haemosiderin at autopsy provided additional supportive evidence of smothering.
代理型孟乔森综合征的特征是父母虚构孩子的病史和/或故意诱发人为疾病。该综合征最初被报道为母亲的一种疾病，现在已知也有男性患者。最常见的特征性表现之一是据称孩子反复出现呼吸暂停发作。实际上，这些是故意诱发的上呼吸道阻塞发作。如果不被识别，这些父母的孩子面临严重伤害或死亡的巨大风险。尸检时识别窒息情况充满困难，肺泡内铁血黄素的存在据称是先前窒息的一个标志。本文报告了一例代理型孟乔森综合征病例，其中存在反复故意实施的部分窒息行为，尸检时发现肺泡内铁血黄素为窒息提供了额外的支持证据。
