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Basil J. Zitelli, MD; Miriam F. Seltman, MSW; Rose Mary Shannon, RN, MN

Am J Dis Child. 1987;141(10):1095-1098.

Abstract
• Physicians and legal and protective service agencies may unwittingly participate in Munchausen's syndrome by Proxy (MSP) when they fail to recognize MSP, treat the true disorder, and effect a favorable outcome for the child. Five Patients with MSP are described, emphasizing a variety of presentations, often with a delay in diagnosis. In addition, features in the family unit are identified to aid in early recognition of the disorder, and a management protocol used at Children's Hospital of Pittsburgh is presented. Finally, the need for better care, recognition, and reporting to help determine the true Incidence of the disorder and aid in educating involved professionals is emphasized.

(AJDC 1987;141:1099-1102)

Author Affiliations
From the Departments of Pediatrics (Dr Zitelli), Clinical Social Work (Ms Seltman), and Nursing (Ms Shannon), The University of Pittsburgh Health Sciences Center, University of Pittsburgh.

Footnotes
Accepted for publication Feb 15, 1987.

Reprint requests to Children's Hospital of Pittsburgh, One Children's Place, 3705 Fifth Ave at DeSoto St, Pittsburgh, PA 15213 (Dr Zitelli).

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