{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:26:14Z","timestamp":1787235974670,"version":"build-2736575974"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hemoptysis in children is typically associated with identifiable organic causes such as respiratory infection, bronchiectasis, or coagulopathy, and is often accompanied by respiratory symptoms or anemia. However, approximately 10\u201325% of pediatric cases remain cryptogenic or represent pseudohemoptysis despite extensive diagnostic evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report a 10-year-old boy presenting with daily recurrent blood-spitting manifested as scant blood-tinged saliva (&amp;lt;5 mL per episode) for 12 months. There were no accompanying respiratory or gastrointestinal symptoms, and no evidence of anemia. A comprehensive multidisciplinary evaluation including otolaryngology, pulmonology, gastroenterology (endoscopy), bronchoscopy, chest computed tomography, and video-electroencephalography revealed no organic source of bleeding. The episodes consistently co-occurred with psychogenic nonepileptic seizures during periods of psychosocial stress, including parental conflict and school-related anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Diagnosis and outcome<\/jats:title>\n                    <jats:p>The patient was diagnosed with functional neurological disorder (FND) according to the DSM-5-TR criteria. Recurrent blood-spitting was interpreted as a somatic symptom occurring within the clinical context of FND. A multidisciplinary treatment approach\u2014including cognitive behavioral therapy, family therapy, pharmacological management, and caregiver psychoeducation\u2014was associated with rapid clinical improvement. At 6-month follow-up, only rare stress-related recurrences were reported. Salivary cytology demonstrated scant erythrocytes without evidence of active bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights a possible clinical association between recurrent blood-spitting and functional neurological disorder in this clinical context. Early recognition of a functional etiology is essential to avoid unnecessary invasive investigations and to facilitate timely psychiatric intervention, leading to favorable clinical outcomes. Given the single-case design, causality cannot be established.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1806567","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T08:12:20Z","timestamp":1778659940000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Recurrent blood-spitting as a somatic presentation of pediatric functional neurological disorder: a case report"],"prefix":"10.3389","volume":"17","author":[{"given":"Tu","family":"DH","sequence":"first","affiliation":[{"name":"Department of Adolescent Health, Vietnam National Children\u2019s Hospital","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huong","family":"NM","sequence":"additional","affiliation":[{"name":"Department of Adolescent Health, Vietnam National Children\u2019s Hospital","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anh","family":"LN","sequence":"additional","affiliation":[{"name":"Department of Adolescent Health, Vietnam National Children\u2019s Hospital","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinh","family":"NA","sequence":"additional","affiliation":[{"name":"Department of Adolescent Health, Vietnam National Children\u2019s Hospital","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1007\/s13312-010-0044-z","article-title":"Hemoptysis in children","volume":"47","author":"Gaude","year":"2010","journal-title":"Indian Pediatr"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/1565030","article-title":"Approach to hemoptysis in the modern era","volume":"2017","author":"Gagnon","year":"2017","journal-title":"Can Respir J"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.4305","article-title":"Hemoptysis in pediatric patients","volume":"11","author":"Naum","year":"2019","journal-title":"Cureus"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1177\/014556139507401209","article-title":"Hemoptysis and pseudohemoptysis: the patient expectorating blood","volume":"74","author":"DiLeo","year":"1995","journal-title":"Ear Nose Throat J"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12356","article-title":"Minimum requirements for the diagnosis of psychogenic nonepileptic seizures: a staged approach: a report from the International League Against Epilepsy Nonepileptic Seizures Task Force","volume":"54","author":"LaFrance","year":"2013","journal-title":"Epilepsia"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12336","article-title":"Psychogenic nonepileptic seizures in children: a review","volume":"54","author":"Reilly","year":"2013","journal-title":"Epilepsia"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.1406","article-title":"Psychogenic nonepileptic seizures in pediatric population: a review","volume":"9","author":"Operto","year":"2019","journal-title":"Brain Behav"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22345","article-title":"Can semiology predict psychogenic nonepileptic seizures? 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