Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

27 June 2018 : Case report  Netherlands

Pediatric Condition Falsification Misdiagnosed by Misjudged Weight Growth from the Curve of Measured Weights

Mistake in diagnosis, Rare disease, Clinical situation which can not be reproduced for ethical reasons

Martin J.C. van Gemert1ABCDEF*, Marianne Vlaming2ABCDEF, Eric Osinga3ACDEF, Cornelis M.A. Bruijninckx4ACDEF, H.A. Martino Neumann5ACDEF, Pieter J.J. Sauer6ACDEF

DOI: 10.12659/AJCR.908770

Am J Case Rep 2018; 19:752-756

Abstract

BACKGROUND: Pediatric condition falsification (PCF) is a rare form of child abuse in which a caregiver fabricates or induces illness in the child. The diagnosis is difficult and controversial and can easily include false positives.

CASE REPORT: A boy, 3.18 kg birthweight (P25 curve), lost weight between age 56 to120 days. Cow milk allergy was suspected, feeding was changed to elementary formula, and he started catch-up weight growth while remaining significantly underweight. His pediatrician continuously interpreted his low weight as insufficient growth, despite prescribing 3 times the normal caloric intake, concluded that the mother purposely malnourished her son, diagnosed PCF, and the boy was separated from his family (days 502–755 of age). PCF was confirmed by 2 other pediatricians and 3 child protection physicians and was supported by 4 child protection agencies and 6 judges. However, proper analysis of the weight growth (kg/year) from the weight curve showed a normal weight gain. Beyond 120 days of age, weight gain at home was significantly above normal (during 347–489 days: 6.2 versus 3 kg/year of the P50). He reached P25 again at around 516 days.

CONCLUSIONS: The question “How could so many physicians misjudge weight gain?” has scientific and sociologic aspects. Scientifically, low weight was wrongly interpreted as insufficient weight growth, requiring that physicians learn how to assess weight gain from weight curves. Sociologically, physicians seem to follow a diagnosis made by a colleague without proper evaluation. Arguments provided by the parents against this diagnosis seemed to be neglected. Confirmation bias occurs when any information against PCF is disregarded.

Keywords: Body Weight, case reports, Diagnostic Errors, Weight Gain

Add Comment 0 Comments

In Press

18 Jan 2024 : Case report  Belgium

A Rare Case of Retroperitoneal Abscess Caused by Nephro-Colic Fistula Resulting from Staghorn Calculus

Am J Case Rep In Press; DOI: 10.12659/AJCR.943206  

0:00

18 Jan 2024 : Case report  USA

A Case of Left-Sided Acute Appendicitis in a 45-Year-Old Man with Situs Inversus Totalis Managed by Emergen...

Am J Case Rep In Press; DOI: 10.12659/AJCR.942323  

0:00

23 Jan 2024 : Case report  USA

Cloacal Dysgenesis Sequence in a Preterm Neonate

Am J Case Rep In Press; DOI: 10.12659/AJCR.942203  

0:00

09 Feb 2024 : Case report  USA

A Case of Trauma-Related Angioedema of the Airway in a Patient on an Angiotensin Receptor Blocker

Am J Case Rep In Press; DOI: 10.12659/AJCR.943407  

0:00

Most Viewed Current Articles

10 Jan 2022 : Case report  Germany

A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...

DOI :10.12659/AJCR.935263

Am J Case Rep 2022; 23:e935263

19 Jul 2022 : Case report  Saudi Arabia

Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19

DOI :10.12659/AJCR.936128

Am J Case Rep 2022; 23:e936128

05 Mar 2022 : Case report  Brazil

Acute Limb Ischemia After Self-Injection of Crushed Morphine Tablets into the Radial Artery: Role of Infrar...

DOI :10.12659/AJCR.935336

Am J Case Rep 2022; 23:e935336

02 Apr 2022 : Case report  Saudi Arabia

Infective Endocarditis Caused by Pseudomonas luteola in a Pediatric Patient. A Case Report and Review of Li...

DOI :10.12659/AJCR.935743

Am J Case Rep 2022; 23:e935743

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923