Doyle believe folie à plusieurs to have been at least a partial factor in the murder of Bridget Cleary. In 1895, Michael Cleary convinced several friends and relatives that his wife, Bridget Cleary, was a changeling who had been replaced by a fairy. They assisted him in physically abusing her to "cast the fairies" out, before he ultimately burned her to death shortly afterwards. Christine and Léa Papin were two French sisters who, as live-in maids, were convicted of murdering their employers wife and daughter in Le Mans, France on February 2, 1933. Born in Yemen in 1963 to Barbados immigrants, June and Jennifer Gibbons were known as "the Silent Twins" for speaking solely to each other in an idioglossia derived from an idiosyncratic, sped-up Bajan Creole dialect that qualified as an example of cryptophasia. The inseparable twins had a longstanding agreement that, if one died, the other must begin to speak and live a normal life, and it was during their 11-year admission to Broadmoor Hospital — where the twins had been indefinitely placed following a series of crimes (e.g. vandalism, petty theft and arson) in 1981 — that they began to believe that it was necessary for one of them to die. Jennifer agreed it should be her, and when the twins were transferred from Broadmoor to the more open Caswell Clinic in Bridgend, Wales in 1993, Jennifer could not be roused upon arrival. She was taken to the hospital where she died soon after of acute myocarditis, or inflammation of the heart.
The oral pigmentations are the first on the body to appear, and thus play an important part in early diagnosis. Intraorally, they are most frequently seen on the gingiva, hard palate and inside of the cheek. The mucosa of the lower lip is almost invariably involved as well. Hamartomatous polyps in the gastrointestinal tract. These are benign polyps with an extraordinarily low potential for malignancy.Having 2 of the 3 listed clinical criteria indicates a positive diagnosis. The oral findings are consistent with other conditions, such as Addisons disease and McCune–Albright syndrome, and these should be included in the differential diagnosis. 90–100% of patients with a clinical diagnosis of PJS have a mutation in the STK11/LKB1 gene. Molecular genetic testing for this mutation is available clinically. Management
Resection of the polyps is required only if serious bleeding or intussusception occurs. Enterotomy is performed for removing large, single nodules. Short lengths of heavily involved intestinal segments can be resected. Colonoscopy can be used to snare the polyps if they are within reach. Prognosis
Most patients will develop flat, brownish spots (melanotic macules) on the skin, especially on the lips and oral mucosa, during the first year of life, and a patients first bowel obstruction due to intussusception usually occurs between the ages of six and 18 years. The cumulative lifetime cancer risk begins to rise in middle age. Cumulative risks by age 70 for all cancers, gastrointestinal (GI) cancers, and pancreatic cancer are 85%, 57%, and 11%, respectively.A 2011 Dutch study followed 133 patients for 14 years.