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Report Discusses Caregiver-Fabricated Illness in Children

Report Discusses Caregiver-Fabricated Illness in Children

Rare but serious form of child maltreatment can result in significant morbidity and mortality

TUESDAY, Aug. 27 (HealthDay News) -- Caregiver-fabricated illness is a rare but serious form of child abuse, and pediatricians should be aware of it when faced with persistent or recurrent illness that cannot be explained, according to a clinical report published online Aug. 26 in Pediatrics.

Emalee G. Flaherty, M.D., and Harriet L. MacMillan, M.D., on behalf of the American Academy of Pediatrics Committee on Child Abuse and Neglect discuss caregiver-fabricated illness in children.

The authors note that caregiver-fabricated illness is a rare but serious form of child maltreatment, which can result in significant morbidity and mortality. Pediatricians should be aware of this possibility when signs and symptoms do not fit a specific disease; when the child appears to be resistant to treatment; or when the illness evolves into another illness. Diagnosis involves a full evaluation of medical records, communication between medical professionals, and often a multidisciplinary approach. Pediatricians should focus on the harm caused to the child by the caregiver's actions and attempts to diagnose and treat a nonexistent illness. Advice and assistance can be requested from local specialists in child abuse pediatrics, if necessary. Diagnosis of this form of child maltreatment does not necessitate a focus on the motives of the caregiver.

"Because it is a relatively uncommon form of maltreatment, pediatricians need to have a high index of suspicion when faced with a persistent or recurrent illness that cannot be explained and that results in multiple medical procedures or when there are discrepancies between the history, physical examination, and health of a child," the authors write.

Abstract (http://pediatrics.aappublications.org/content/early/2013/08/20/peds.2013-2045.abstract )Full Text (http://pediatrics.aappublications.org/content/early/2013/08/20/peds.2013-2045.full.pdf+html )