Fabricated or Induced Illness Case 3

1. Question

A 6-year-old boy comes into the ED with his mother. He was referred up by his GP with haematuria on dipstick sample of urine. His examination is unremarkable.

Match the clinical finding or investigation result with the likely diagnosis.

Sort elements

Post-Streptococcal Glomerulonephritis
Henoch Schonlein Purpura (HSP)
Haemolytivc Uraemic Syndrome (HUS)
Nephroblastoma (Wilms tumour)
Urinary tract infection

Raised Antistreptolysin O titre (ASOT)
Non-blanching spots on buttocks and legs
Bloody diarrhoea with impaired renal function
Abdominal mass and aniridia
Fever and painful micturition

2. Question

He returns 2 days later. Mum reports that he has abdominal pain. They have brought a urine sample from home. It shows ++++ protein on dipstick but no blood.

Give 4 features on examination that you would look for in Nephrotic Syndrome.

3. Question

His weight is unchanged from his previous visit and his examination and repeat urine dipstick are both entirely normal.

Give 2 reasons why this story is concerning for FII.

4. Question

While the Mum is out of the room the child tells you that “Mum put an egg in my wee”.

Give 3 actions you should take.