In my previous posts, I talked about the top three type of Munchausen Syndrome by Proxy (MSbP) poisoning – tranquilizers/anti-depressants, insulin, and emetics – I found in a review of 87 case studies of MSbP poisoning going back to 1965. In this post, I’m going to talk about a few miscellaneous types of MSbP poisoning that showed up on the radar as well.
Laxatives and Diet Pills
A baby who was adopted at age 3 weeks got acute enteritis at 5 months which resolved within a week. Then, until he was 3 years old, he’d go through periods of time where he had intractable diarrhea. Eventually, they thought to do toxicology on the stools and found his mother was feeding him laxatives. Similarly, an earlier article from 1978 describes poisoning of two siblings with phentermine, a diet pill.
“Intentional poisoning with prescription drugs was used by the mother to simulate an underlying disease in her two children. Combined with misleading history and interference with laboratory procedures, she confounded physicians for years, and led to unnecessary hospitalizations, treatment and multiple laboratory procedures for these children.”
Blood Thinners – Especially Warfarin
Warfarin (also known as Coumadin) is often prescribed to people at risk for stroke, because it is a blood thinner that lowers the chance of blot clots forming. Of course, overuse leads to uncontrolled bleeding.
Warfarin poisoning is used in MSbP in case studies I reviewed back to 1985, when a nurse’s aide who has previously been prescribed warfarin gave it to her 11-month-old black baby girl until she started bleeding from her ears. In a more recent case from Turkey, warfarin poisoning was detected in a 14-year-old victim.
Caustics, Salt, and Other Goodies
I came across quite a few articles that talked about poisoning with “caustics” – meaning things like bleach, that burned the victim’s esophagus. In this case series of two siblings, one who died, the other was diagnosed as an MSbP victim after toxicology revealed that the mother was feeding her children a household-cleaning product, sodium hydroxide.
Salt Intoxication and Poisoning
Salt is also a popular poison among MSbP perpetrators, and they either administer it orally, intravenously, or through feeding tubes. In this 2010 article, an 8-week-old infant with diarrhea and excessive fluid output was diagnosed with salt intoxication, and it was found that the mother had put salt in the child’s nasogastric tube. Again, toxicology revealing salt intoxication (along with creative thinking) was necessary to figure this one out.
A Few Other Examples
Anything the perpetrator can access can be used as a poison.
- Rat poison: This 24-month-old ingested “superwarfarin” or brodifacoum which is a rodenticide. He was in the hospital 10 days before they figured out the mother was the source.
- Antihistamine: This article talks about two siblings poisoned by their mother with diphenhydramine.
- Anticonvulsants: This preschooler endured “chemical abuse” until pharmacokinetics saved the day.
- A few others: Infant poisoned with caffeine, a perpetrator using tetrahydrozoline (eye drops), and a 4.5 year old boy poisoned with frusemide (a diuretic).
Recognizing MSbP Poisoning
This summarizes common modes of poisoning in MSbP. Clever use of toxicology helped save those victims who survived. However, many times it is not clear that the victim is being poisoned or with what. It just becomes clear that when the victim is removed from the perpetrator, the illness resolves.
In my next post, I will describe my mother’s approach to causing toxicity in myself, my brother and my father, which was through using vitamins.
Interested in a recent case of MSbP in the news?
Jessica Valik is accused of putting something in her 4-year-old’s feeding tube.