Factitious disorders in the hand–Main diagnostic traps highlighted with 3 cases

Bachy, Manon; Moncany, Anne-Hélène; Tournier, Clara; Lievain, L.; Fitoussi, Franck; Vialle, Raphaël; Auquit-Auckbur, I.

doi:10.1016/j.hansur.2017.10.237

Cited by 3 publications

(35 citation statements)

References 14 publications

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“…Following successful fasciotomy, the patient was found to be selfmutilating in the hospital, and it was presumed that self-harm caused compartment syndrome of the hand. 40 Severe local limb infection, including necrotising fasciitis, may also lead to ALCS in association with infective signs. 41 Non-necrotising fasciitis, cellulitis and sepsis were also reported.…”

Section: Discussionmentioning

confidence: 99%

“…In this case, the patient gave a history of subacute minor hand injury inconsistent with their clinical signs of ALCS. Following successful fasciotomy, the patient was found to be self‐mutilating in the hospital, and it was presumed that self‐harm caused compartment syndrome of the hand 40 …”

Section: Discussionmentioning

confidence: 99%

“…Following successful fasciotomy, the patient was found to be self‐mutilating in the hospital, and it was presumed that self‐harm caused compartment syndrome of the hand. 40 …”

Section: Discussionmentioning

confidence: 99%

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Review article: A comprehensive review of unusual causes of acute limb compartment syndrome

Steadman

Hamilton

et al. 2022

Emerg Medicine Australasia

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Acute limb compartment syndrome (ALCS) is a surgical emergency that can have serious consequences unless promptly diagnosed and treated, which is particularly challenging when there is an unusual cause. This is a comprehensive review of reported causes of ALCS. From 1068 included articles, we found 299 discrete causes of ALCS including toxins, infections, endocrine pathology, haematological emergencies, malignancy and iatrogenic ALCS. Familiarity with this wide range of ALCS causes may assist in early diagnosis of this limb-threatening condition.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Review article: A comprehensive review of unusual causes of acute limb compartment syndrome

Steadman

Hamilton

et al. 2022

Emerg Medicine Australasia

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“…He named the syndrome after the heroine in Barbey d'Aurevilly's novel, “The Story without a Name” [ 2 , 5 , 6 ]. In 1977, pediatrician Roy Meadow introduced the term “Munchausen syndrome by proxy” to describe a variation of child abuse where some caregivers consistently fabricate stories and evidence, subjecting their dependents to unnecessary medical investigations and operations [ 2 , 3 , 5 , 6 ]. A year later, Wallace and Fitzmorris describe the SHAFT syndrome (Sad, Hostil, Anxious, Frustrating, Tenacious), as a passive variant of MS, where the patient induces the professionals to cause injuries by unnecessary procedures [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Factitious disorders, particularly MS, entail a risk of excessive clinical interventions, resulting in significant sociofamilial, occupational, and financial impacts [ 3 , 7 - 9 ]. Individuals with MS often exhibit chronic and extreme patterns, involving multiple hospitalizations, navigating various healthcare units, and seeking unnecessary medical-surgical procedures [ 1 , 3 , 5 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Munchausen Syndrome in the Context of Liaison Psychiatry: A Case Report and a Narrative Review

Nombora,

Mendes,

Oliveira

et al. 2024

Cureus

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Munchausen Syndrome (MS) has been widely recognized as a severe manifestation of factitious disorder, a condition where individuals intentionally fabricate or exaggerate symptoms for psychological gratification. It represents a complex diagnostic challenge due to its elusive nature and intricate relationship with various medical conditions. We present a clinical case of a 44-year-old woman observed in the context of Liaison Psychiatry, demonstrating the intricate interplay between chronic medical conditions, psychiatric factors, and the challenges in diagnosing and managing MS. The patient exhibited a history of recurrent hospitalizations, difficult-to-heal injuries, and a pronounced preference for surgical interventions. Despite diagnostic difficulties and poor therapeutic adherence, a multidisciplinary team approach involving plastic surgery, orthopedics, physical medicine, and rehabilitation, alongside Liaison Psychiatry, led to the diagnosis of MS with chronic osteomyelitis, ultimately necessitating a transtibial amputation. The case underscores the importance of early detection, a multidisciplinary approach, and the role of Liaison Psychiatry in managing MS. While early diagnosis may not alter the disease course, it can prevent unnecessary interventions and mitigate associated risks. The case also highlights the need for continuous psychiatric support and family involvement in addressing the recurrence of self-injurious behaviors. Further research is essential to enhance our understanding and develop effective treatment strategies for MS, contributing to improved diagnostic precision and overall management of this challenging psychiatric disorder.

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Drug-Induced Undifferentiated Connective Tissue Disease in a Two-Year-Old Girl: A Manifestation of Factitious Disorder Imposed on Another (FDIA)

Oppan,

Otupri

2024

Cureus

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Factitious disorder imposed on another (FDIA), formerly known as Munchausen syndrome by proxy (MSBP), constitutes a form of child abuse wherein a caregiver fabricates or induces illness in a person under their care or supervision. Here, we present a case of a two-year-old girl with signs and symptoms suggestive of undifferentiated connective tissue disease (UCTD) and probable autoinflammatory disease, which was a manifestation of FDIA. The patient manifested recurrent febrile episodes and presented with hepatosplenomegaly, elevated inflammatory markers, and mesangial proliferative glomerulonephritis. Regardless of extensive medical interventions, including corticosteroids and immunosuppressive therapy, the patient's condition failed to improve until the caregiver was isolated from the patient. Upon questioning, the caregiver admitted to having administered pyrogenal, an immunomodulator, to induce symptoms. This case highlights the challenges and difficulties of diagnosing and managing FDIA-associated illnesses, drawing attention to the importance of considering this diagnosis in cases of unexplained or recurrent fever in children.

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Factitious disorders in the hand–Main diagnostic traps highlighted with 3 cases

Cited by 3 publications

References 14 publications

Review article: A comprehensive review of unusual causes of acute limb compartment syndrome

Review article: A comprehensive review of unusual causes of acute limb compartment syndrome

Munchausen Syndrome in the Context of Liaison Psychiatry: A Case Report and a Narrative Review

Drug-Induced Undifferentiated Connective Tissue Disease in a Two-Year-Old Girl: A Manifestation of Factitious Disorder Imposed on Another (FDIA)

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