代理型孟乔森综合征：一例报告。
Munchausen syndrome by proxy: a case report.
机构信息
Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Al Takhassousi & 12713, Riyadh, 11211, Saudi Arabia.
出版信息
J Med Case Rep. 2023 Apr 4;17(1):148. doi: 10.1186/s13256-023-03848-7.
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.
背景
不适当的高水平胰岛素分泌可导致潜在致命的婴儿持续性高胰岛素血症性低血糖。我们的论文侧重于另一种严重低血糖的原因，这种原因很容易被忽视。
病例介绍
一名 18 个月大的沙特女性因反复发作的低血糖发作被转介到我们医院进行进一步检查和治疗，她被诊断为婴儿持续性高胰岛素血症性低血糖。在住院期间，我们从病史中注意到多个危险信号；母亲坚持要进行胰腺切除术，而不是进行正电子发射断层扫描，最重要的是，所有低血糖发作都发生在母亲身边。因此，进一步调查后，该病例被诊断为照料者制造的疾病，并将该病例转介到儿童保护中心。
结论
必须高度怀疑照料者制造的疾病。医生应该更加注意预防这种疾病，如果不及时发现，这种疾病最终可能会致命。
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