Caso contributivo
I love (doctor) shopping…
I love (doctor) shopping…
Francesca Belcari, Silvia Agostiniani, Gloria Rossi, Maria Costanza Caparello, Rita Consolini
Pediatria, Azienda Ospedaliera-Universitaria Pisana, Servizio di Immunologia Pediatrica, Pisa
Maggio 2016
Abstract
A thirteen-year-old boy presented with recurrent fever for two years and was checked up in several hospitals with the only outcome of hypogammaglobulinemia. He could not go to school for 90 days. He underwent clinical examination and lab tests that showed negative results and no fever. A moderate hypogammaglobulinemia was confirmed but not as cause of the fever. The patient was therefore examined for 24 hours to check fever and his clinical status directly. Every time he was afebrile. “Factitia fever” was suspected and the patient addressed to a neuropsychiatric evaluation that evidenced: “fear of competition with classmates and a pathological relationship with his mother”. So, neuropsychiatric procedure was suggested. His mother seemed to understand, but after a few minutes she asked: “Who is the best doctor in the Clinic? I would like to take my son to check his hypogammaglobulinemia”. And a new doctor shopping was starting again…
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Bibliografia
Tommasini A, Insalaco A, Rodriguez Perez C, Soresina AR, Plebani A. Quando sospettare un'immunodeficienza. Medico e Bambino 2001;8:524-8.
ESID Registry. Working definitions for clinical diagnosis of PID. May 11, 2015.
Vezzetti V. Un abuso molto particolare. Medico e Bambino pagine elettroniche 2014;17(1).
AAVV. La sindrome di Münchausen by proxy. Medico e Bambino 2014;33:497-510.
Royal College of Paediatrics and Child Health. Fabricated or Induced Illness by Carers (FII): A practical guide for Paediatricians. Royal College of Paediatrics and Child Health, 2009.
McClure RJ, Davis PM, Meadow SR, Sibert JR. Epidemiology of Münchausen syndrome by proxy, non-accidental poisoning, and non-accidental suffocation. Arch Dis Child 1996;75:57-61.
Rosenberg DA. Münchausen Syndrome by Proxy. medical diagnostic criteria. Child Abuse Negl 2003;27(4):421-30.
Munckhof WJ, Jenkins K. Factitious acquired immunodeficiency syndrome (AIDS). Aust N Z J Med 1993;23(5):524-5.
Aleem A, Ajarim DS. Münchausen syndrome - presenting as immunodeficiency: A case report and review of the literature. Ann Saudi Med 1995;15(4):404-6.
Ameratunga R, Casey P, Parry S, Kenedi C. Hypogammaglobulinemia factitia - Münchausen syndrome masquerading as common variable immune deficiency. Allergy Asthma Clin Immunol 2013;9(1):36.