Klepper Jörg, Heringhaus Anja, Wurthmann Cornelius, Voit Thomas
Children's Hospital, Am Hasenkopf, 63739, Aschaffenburg, Germany.
Eur J Pediatr. 2008 Sep;167(9):1085-8. doi: 10.1007/s00431-007-0627-4. Epub 2007 Nov 7.
Munchausen by proxy syndrome (MBPS) is a form of child abuse wherein the mother fabricates or produces illness in her child. The condition is hard to diagnose and few successful interventions have been described. Long-term outcome is associated with high family disruption, reabuse, mortality and morbidity. We report on a six-month-old girl that experienced eight hospital admissions within five months. Symptoms of repeated vomiting, bloody diarrhoea and acute life-threatening events (ALTE) were never substantiated. Finally, blood in diapers and napkins presented by the mother was shown to be of maternal origin. When confronted, the mother agreed to psychiatric admission. Following five months of treatment, her mental state stabilised and she entered supported living. She remained separated from the child, who was given to the father and developed normally on close paediatric follow-up. We report a definite diagnosis and successful intervention in MBPS. The case highlights characteristic features of this entity and illustrates that a favourable outcome depends on early intervention with separation of the child and perpetrator, as well as concomitant long-term psychiatric treatment.
代理型孟乔森综合征（MBPS）是一种虐待儿童的形式，即母亲编造或致使孩子生病。这种病症难以诊断，且鲜有成功干预措施的报道。长期预后与家庭高度破裂、再次受虐、死亡率和发病率相关。我们报告一例六个月大的女童，在五个月内八次入院。反复呕吐、血性腹泻和急性危及生命事件（ALTE）的症状从未得到证实。最后，母亲出示的尿布和餐巾上的血迹被证明来自母亲。当面对这一情况时，母亲同意接受精神科住院治疗。经过五个月的治疗，她的精神状态稳定下来，并进入了支持性居住环境。她与孩子仍然分开，孩子被交给了父亲，并在密切的儿科随访中正常发育。我们报告了对代理型孟乔森综合征的明确诊断和成功干预。该病例突出了这一病症的特征，并表明良好的预后取决于早期干预，包括将孩子与施虐者分开，以及同时进行长期的精神科治疗。
