Factitious hypoglycemia: a tale from the Arab world.
The mother is usually the one who narrates the patient's history to the pediatrician. Listening and eliciting the parent's story is an art. One of the essential attributes of a good pediatrician is the readiness to believe the parent's story. Mothers are good historians and careful observers. The axiom that the mother is always right is true in most instances. However, occasionally the clinician is deliberately misled by the storyteller, resulting in numerous and potentially dangerous diagnostic investigations. We describe a boy with recurrent hypoglycemic coma in whom the diagnosis of factitious hypoglycemia was delayed as it is believed to be nonexistent in our community. We emphasize that in all patients with recurrent hypoglycemia, estimation of C-peptide and insulin should be performed even when the clinical settings are not in favor of the diagnosis of Munchausen syndrome by proxy. Munchausen syndrome by proxy, hypoglycemia.
Bappal
B
B
Department of Pediatric Endocrinology, Royal Hospital, Seeb-111, Muscat, Sultanate of Oman. bappal@omantel.net
George
M
M
Nair
R
R
Khusaiby
S A
SA
De Silva
V
V
D002649:Child Abuse / Q000175:diagnosis*; D002675:Child, Preschool; D003937:Diagnosis, Differential; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000175:diagnosis*; D007328:Insulin / Q000506:poisoning*; D008297:Male; D009035:Mothers; D009110:Munchausen Syndrome / Q000175:diagnosis*; D012008:Recurrence
D007328:Insulin