ABSTRACT
OBJECTIVE: To present a case of Munchausen syndrome by proxy caused by ipecac poisoning to increase the awareness of their warning signs and symptoms so that they may be recognized and diagnosed earlier. CASE: Report of one case of a child who was determined to be a victim of Munchausen syndrome by proxy by ipecac poisoning who was hospitalized multiple times over a 4-year period at 2 different hospitals before an accurate diagnosis was made.
Subject(s)
Ipecac/poisoning , Munchausen Syndrome by Proxy/chemically induced , Child , Humans , Male , Munchausen Syndrome by Proxy/diagnosisABSTRACT
A patient with anorexia nervosa developed a fatal cardiomyopathy due to ipecac intoxication. Prodromal signs and symptoms included generalized muscle weakness, dysphagia, and severe palpitations. Autopsy revealed pathological changes in the heart and skeletal muscles.
Subject(s)
Anorexia Nervosa/psychology , Ipecac/poisoning , Adult , Emetine/poisoning , Female , Heart Diseases/chemically induced , Humans , Muscular Diseases/chemically inducedABSTRACT
The intentional poisoning of two children with ipecac by their mothers is described. Intractable vomiting and diarrhea were the initial symptoms in both patients. In addition, one patient had clinical and laboratory evidence of skeletal and cardiac myopathy. Both children were subjected to extensive and invasive diagnostic evaluations before the correct diagnosis of chronic ipecac poisoning was made. These cases illustrate the toxic effects of ipecac ingestion and serve to alert physicians to child abuse by ipecac poisoning.
Subject(s)
Child Abuse , Ipecac/poisoning , Munchausen Syndrome/diagnosis , Child , Humans , Infant , Male , Muscular Diseases/chemically induced , Vomiting/chemically inducedABSTRACT
A 17-year-old girl presented with malaise, weakness, palpitations, dysphagia, myalgias, and weight loss of 1 month's duration. Within 24 hours of admission to the hospital, she had hypotension unresponsive to medical management, intractable congestive heart failure, and arrhythmias; she died. Several empty bottles of syrup of ipecac were later found among her belongings. Syrup of ipecac is commonly used to induce emesis in patients who had ingested toxic substances. The chief pharmacologic property of this agent is due to its alkaloid component, emetine. There have been many previous reports of death due to emetine poisoning in patients receiving ipecac fluid extract and in those treated for amoebic dysentery. However, the literature cites only three case reports of fatalities secondary to chronic ipecac use as a means of losing weight. This is the first report of a death due to chronic ipecac use in an adolescent patient with bulimia. Emetine persists in the body for long periods, and in patients who have ingested it chronically, emetine is extremely toxic, specifically to cardiac smooth and skeletal muscles. With an increased awareness of the importance of weight control in the adolescent age group, the physician must carefully evaluate these patients for the use of emetics.
Subject(s)
Feeding and Eating Disorders/psychology , Hyperphagia/psychology , Ipecac/poisoning , Adolescent , Cardiomyopathies/chemically induced , Cardiomyopathies/pathology , Emetine/poisoning , Female , Humans , Hyperphagia/pathology , NecrosisABSTRACT
We have compiled a list of common household products and drugs that are frequently ingested by children and may be considered nontoxic unless taken deliberately or in large amounts. An understanding of the nontoxic ingestion should prevent overtreatment, decrease emergency room visits, and allow physicians and poison control centers the opportunity to practice poison prevention. The reporting of all ingestions is encouraged to obtain information on the human experiment that occurs when a non-edible material is ingested. Only as we accumulate this knowledge will we be able to advise with a degree of certainty what treatment is needed.
Subject(s)
Household Products , Poison Control Centers/statistics & numerical data , Poisoning/prevention & control , Adhesives , Alcoholic Intoxication/therapy , Animals , Child, Preschool , Communication , Contraceptives, Oral, Hormonal , Cosmetics , Detergents , Emergency Service, Hospital/statistics & numerical data , Emetics/therapeutic use , Foreign Bodies , Gastric Lavage , Household Products/poisoning , Humans , Infant , Ink , Ipecac/poisoning , Mercury , Nonprescription Drugs , Paint , Pesticides , Petroleum , Plants, Toxic , Poisoning/etiology , Product Labeling , Sweetening Agents , NicotianaSubject(s)
Ipecac/poisoning , Chronic Disease , Female , Humans , Infant , Munchausen Syndrome/diagnosis , Muscle Hypotonia/chemically inducedSubject(s)
Cardiomyopathy, Dilated/chemically induced , Ipecac/poisoning , Munchausen Syndrome by Proxy , Adult , Child, Preschool , Diarrhea/chemically induced , Female , Humans , Ipecac/administration & dosage , Male , Munchausen Syndrome by Proxy/chemically induced , Munchausen Syndrome by Proxy/diagnosis , Time Factors , Vomiting/chemically inducedSubject(s)
Bulimia , Ipecac/poisoning , Adolescent , Female , Humans , Risk , Vomiting/chemically inducedABSTRACT
Ipecac (emetine) is a safe emetic for emergency home use. Its ready availability also provides the potential for child abuse and chronic self-induced emesis. The chronic administration of Ipecac can result in unusual symptom complexes such as chronic diarrhea and vomiting, muscle weakness, colitis, cardiomyopathy, fever, edema, or electrolyte disturbances. We describe patients who were intentionally poisoned and who demonstrated these symptoms. Because of the widespread use of ipecac for therapy in acute accidental poisonings, toxicology laboratories may not look for or report the presence of this drug in their routine screens. This may delay the recognition of chronic ipecac poisoning in patients.