Assuntos
Pressão Sanguínea , Proteínas do Ovo/urina , Hipertensão/diagnóstico , Síndrome de Munchausen/diagnóstico , Síndrome Nefrótica/diagnóstico , Proteinúria/diagnóstico , Idoso , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Resistência a Medicamentos , Feminino , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Hipertensão/fisiopatologia , Adesão à Medicação , Síndrome Nefrótica/complicações , Síndrome Nefrótica/urina , Proteinúria/complicações , Proteinúria/urina , Fitas Reagentes , UrináliseRESUMO
A five-year-old girl presented with profound growth failure, lethargy, vomiting and acidosis. A diagnosis of Munchausen syndrome by proxy was made after the demonstration of egg albumin, diphenhydramine and phenothiazine metabolites in her urine. Growth improved dramatically, but a subsequent child in the family died of sudden infant death syndrome.
Assuntos
Albuminúria/induzido quimicamente , Transtornos do Crescimento/induzido quimicamente , Síndrome de Munchausen Causada por Terceiro/diagnóstico , Albuminúria/sangue , Albuminúria/urina , Pré-Escolar , Difenidramina/urina , Proteínas do Ovo/urina , Feminino , Transtornos do Crescimento/sangue , Transtornos do Crescimento/urina , Hormônio do Crescimento/sangue , Humanos , Síndrome de Munchausen Causada por Terceiro/complicações , Fenotiazinas/urinaRESUMO
A 16-year-old girl showed waxing and waning proteinuria and fat globules in urine for three years. There were no other abnormal findings except for the urinalysis. The renal biopsy findings did not indicate glomerular disease. Electrophoresis of the urinary protein showed two abnormal fractions at the alpha and beta globulins. Immunoelectrophoresis demonstrated that these abnormal proteins were not derived from human serum proteins, but were egg proteins. It appears that the proteinuria was factitious and that egg proteins were injected into the bladder, as they were also present in the bladder urine.
