• Ann Emerg Med · Aug 1998

    Case Reports

    Two siblings poisoned with diphenhydramine: a case of factitious disorder by proxy.

    • S M Arnold, D Arnholz, G T Garyfallou, and K Heard.
    • Colorado Permanente Medical Group, University of Colorado School of Medicine, The Children's Hospital, Denver, USA.
    • Ann Emerg Med. 1998 Aug 1; 32 (2): 256-9.

    AbstractWe report a case of factitious disorder by proxy (FDBP), formerly known as Munchausen syndrome by proxy, in which 2 siblings were poisoned with diphenhydramine. Although diphenhydramine is a readily available medication, no report of its use as the sole agent in an FDBP case was found in a literature search. Although sibling involvement in FDBP is well documented, this is the first case report of 2 siblings hospitalized simultaneously because of intentional poisoning with the same substance. Finally, the use of physostigmine to definitively diagnose anticholinergic poisoning in a case of FDBP has not previously been described.

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