title: [Two cases of suspected Munchausen by proxy syndrome: the importance of forensic toxicological analyses in handling suspicions and producing evidence].
abstract: The authors report on two cases of suspected Munchausen by proxy syndrome. In a 3-year-old boy, clinical toxicological analyses produced suspicious clues that an antidepressant had been administered, which could not be verified by forensic toxicological investigations. In a 13-month-old boy, the mother was also suspected of having poisoned the child. Initial clinical toxicological examinations failed to explain the observed symptoms (unclear unconsciousness, narrowed pupils). While in the first case, the incorrect interpretation of findings by a laboratory without forensic experience resulted in suspicions against the mother, the cause for the observed symptoms in the second case could be proved by complex analyses not performed before and the suspicion that the clinical picture had been intentionally brought about could be cleared up (use of an antitussive containing clobutinol). The two reports show that especially in cases with a potential forensic background, adequately qualified forensic laboratories with a broad spectrum of analytical methods should be involved.
authors.affiliation: Institut für Rechtsmedizin des Universitätsklinikums Bonn.
authors.forename: Frank
authors.initials: F
authors.lastname: Musshoff
authors.forename: Katrin M
authors.initials: KM
authors.lastname: Kirschbaum
authors.forename: Burkhard
authors.initials: B
authors.lastname: Madea
mesh_terms: D000605:Amino Alcohols / Q000032:analysis*; D000929:Antidepressive Agents, Tricyclic / Q000032:analysis*; D000996:Antitussive Agents / Q000032:analysis*; D002669:Child Welfare / Q000331:legislation & jurisprudence; D002675:Child, Preschool; D003891:Desipramine / Q000032:analysis*; D005104:Expert Testimony / Q000331:legislation & jurisprudence*; D005189:False Positive Reactions; D006801:Humans; D007223:Infant; D008297:Male; D016735:Munchausen Syndrome by Proxy / Q000175:diagnosis*
chemical_list: D000605:Amino Alcohols; D000929:Antidepressive Agents, Tricyclic; D000996:Antitussive Agents; C017135:clobutinol; D003891:Desipramine