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Munchausen syndrome by proxy
Other Resources UpToDate PubMed

Munchausen syndrome by proxy

Contributors: Michael W. Winter MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed

Synopsis

Munchausen syndrome by proxy, also termed medical child abuse, is a psychiatric condition characterized by the infliction of illness or injury by one individual onto another. This is often a parent causing illness to their child for psychiatric reasons rather than to inflict harm.

Clinical presentation can vary widely as affected individuals can appear as injured or ill from any number of diseases, but commonly these patients are high utilizers of the health care system who have symptoms that are not well explained by a known medical condition. Children affected by Munchausen syndrome by proxy can present with fabricated stories of medical illness or inflicted medical illness by their caretaker, and they are consequentially subject to extensive medical testing and treatment.

Many patients will improve during hospital observation but worsen after discharge when they return to their abusive environment.

Related topics: child abuse, Munchausen syndrome

Codes

ICD10CM:
F68.A – Factitious disorder imposed on another

SNOMEDCT:
95637005 – Munchausen syndrome by proxy

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

The differential diagnosis is broad, but consider disorders with intermittent signs and symptoms, especially rare or uncommon ones. Possibilities include:

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:07/29/2020
Last Updated:07/31/2020
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