Sohrab Naushad Ali, Aymon Naushad Ali, Mian Naushad Ali.
Manchausen syndrome by proxy: the overlooked diagnosis.
J Ayub Med Coll Abottabad Jan ;27(2):489-91.

Manchausen Syndrome by Proxy (MSBP) is a psychiatric disorder characterised by the adoption of bizarre behavioural patterns by care-givers in which diseases or disorders are fabricated in individuals, usually children, for purposes which span feelings of superiority derived from deceit of persons deemed superior to the care-giver, or attention seeking. The patient under discussion was a 6 year old male brought to the hospital by his mother with complaints of repetitive and unceasing passing of stones per urethra. Upon inspection of stone specimens brought in by the parents and physical examination, the stones in question were observed to be common stones, with no reason to suggest a urolithiatic origin, leading to the suspicion of MSBP. Further questioning of both the mother and father revealed more information regarding the cause of her child's illness and strongly suggested that the stones were being physically inserted into the child's urethra by the mother - often in the father's absence - after administration of sedative-hypnotic drugs.

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