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Fabricated or induced illness — DCH MCQ

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HardSafeguardingFabricated or induced illnessDCH

A 7-year-old girl has recurrent unexplained hypoglycaemia during admissions, but episodes occur when her mother is present and stop during supervised separation. Extensive endocrine testing has been normal. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Discuss urgently with the safeguarding team

This pattern raises concern for fabricated or induced illness and needs urgent multidisciplinary safeguarding discussion. Dietetic review or further endocrine testing alone would miss a potential harm mechanism. The pearl is to avoid confrontational accusations and follow local safeguarding procedures.

Reference: NICE CG89; RCPCH Child Protection Companion