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- Factitious disorder imposed on another (FDIA) is a type of child abuse where a caregiver fakes or causes illness in someone they care for, previously known as Munchausen syndrome by proxy.
- A case study of a two-year-old girl showed symptoms resembling a serious autoimmune disease, but it turned out to be induced by her caregiver, who was secretly giving her a medication to simulate illness.
- The girl did not improve despite medical treatment until the caregiver was separated, demonstrating the need for healthcare providers to consider FDIA when faced with unexplained or recurring health issues in children.
Clinical Presentation, Diagnosis, and Management of Hyperinsulinemic Hypoglycemia in Adults: A Single-center Experience.
Endocr Metab Immune Disord Drug Targets
May 2024
Internal Medicine Unit, Section of Endocrinology, ENETS Center of Excellence, University Hospital of Verona, Italy.
Introduction: Hyperinsulinemic Hypoglycemia (HH) is a rare condition characterized by inappropriately elevated insulin levels in the presence of low glucose levels. A proper diagnostic framework is fundamental to avoid patients undergoing unnecessary diagnostic and therapeutic invasive procedures.
Objective: The study aimed to assess the clinical presentation, diagnostic work-up, and treatment of a single-center cohort of patients affected by HH.
Spurious hyperphosphatemia, a rare occurrence, typically arises from substances in a patient's blood interfering with the colorimetric method for serum phosphate measurement. We present a case of factitious hyperphosphatemia caused by alteplase-contaminated blood samples in an 88-year-old CKD patient on hemodialysis, leading to misleadingly high phosphorus levels. Thorough investigations ruled out other etiologies, highlighting the necessity of stringent adherence to blood collection protocols to prevent sample contamination and avert erroneous laboratory results.
View Article and Find Full Text PDFInsulin Immunoassay Interference Due to Human Antimouse Antibodies in a Patient With Ketotic Hypoglycemia.
JCEM Case Rep
March 2023
Division of Endocrinology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Misinterpretation of common endocrine hormonal immunoassays can distort the clinical picture and lead to unnecessary medical workups. Potential assay inference is important to recognize when the clinical presentation and laboratory evaluation are inconsistent. This is demonstrated by the case of an 18-month-old girl who initially presented with ketotic hypoglycemia and was found on diagnostic fasting evaluation to have the triad of hypoglycemia, inappropriately high insulin levels, and low C-peptide levels-point-of-care glucose 43 mg/dL (2.
View Article and Find Full Text PDFUnlabelled: Two hospitals noted increased newborn hyperbilirubinemia coinciding with an undisclosed total serum bilirubin (TSB) assay change. Clinicians rapidly applied quality improvement methodologies to ascertain increased jaundice evaluations, readmissions, and possible safety issues.
Methods: In January 2020, 2 hospitals (A and B) transitioned to a new method of measuring TSB using a new clinical chemistry analyzer (Siemens Atellica CH), which measured TSB by vanadate oxidase assay instead of the previous diazo assay.
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