为了准确诊断虐待或忽视儿童,医生需要熟悉可以模拟虐待的疾病和医疗条件。不被承认的虐待案件可能导致儿童保护不足,然而,另一方面,过度诊断可能是家庭及其潜在被告成员出现各种问题的原因。关于虐待儿童,科学文献中描述了许多错误的诊断与未发现的出血原因,但是,特别是关于儿童白血病,只有很少的病例报告存在。这里,第一次,我们报告了一个2岁男孩因可疑伤害和社会心理问题两次住院的案例,在一个以反复危害儿童福祉而闻名的家庭情况下。在他第一次因虐待儿童而受伤后,但没有副临床异常,定期安排医疗检查。五个月后,这名儿童再次住院,有反复虐待儿童的迹象。第二次录取时,间歇性实验室检查发现急性淋巴细胞白血病,由于形态变化的新瘀伤而订购,可识别为瘀点出血。该案例阐明了对与可疑虐待儿童有关的儿童白血病已知病例的讨论,以概述模仿虐待的可能疾病。安排必要的支持性检查,儿科医生和法医病理学家之间的巧妙互动对于区分意外伤害和非意外伤害至关重要。
In order to accurately diagnose child abuse or neglect, a physician needs to be familiar with diseases and medical conditions that can simulate maltreatment. Unrecognized cases of abuse may lead to insufficient child protection, whereas, on the other hand, over-diagnosis could be the cause of various problems for the family and their potentially accused members. Regarding child abuse, numerous cases of false diagnoses with undetected causes of bleeding are described in the scientific literature, but, specifically concerning leukemia in childhood, only very few
case reports exist. Here, for the first time, we report a
case of a 2-year-old boy who got hospitalized twice because of suspicious injuries and psychosocial conspicuities, in a family situation known for repeated endangerment of the child\'s well-being. After his first hospitalization with injuries typical for child abuse, but without paraclinical abnormalities, medical inspections were arranged periodically. The child was hospitalized with signs of repeated child abuse again five months later. During second admission, an acute lymphoblastic leukemia was revealed by intermittent laboratory examination, ordered due to new bruises with changes in morphology, identifiable as petechial hemorrhages. This
case elucidates the discussion of known cases of leukemia in childhood associated with suspected child abuse in order to provide an overview of possible diseases mimicking maltreatment. To arrange necessary supportive examinations, a skillful interaction between pediatrician and forensic pathologist is crucial in the differentiation between accidental and non-accidental injury.