I reperti insoliti necessitano di indagini approfondite
Unusual findings need attentive investigation

AUTORI

ABSTRACT

Unusual findings need attentive investigation

We report the case of a 1.5-year-old male child referred to secondary care with an unusual presentation of a highly concentrated urine sediment of red color. Urine microscope analysis showed viscous large red spots suggesting the presence of an exogenous contaminant. Infrared spectroscopy revealed traces of seeds, crumbs and bread crust; chromatographic analysis showed high levels of lycopene and β-carotene, aliphatic hydrocarbon carotenoids extracted from plants like tomatoes, papayas, and watermelons not normally detectable in urine. Clinical history of multiple hospitalization for unexplained persistent or recurrent hematuria, discrepancy between clinical findings and medical history, inconsistent with the child’s overall health, alteration of urinary parameters in samples collected at home or delivered by the mother, sometimes not confirmed in samples collected by nursing staff, were suggestive of factitious disorder imposed an another (FDIA) or Munchausen syndrome by proxy

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