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Scurvy: a case report.

S Chatproedprai¹, S Wananukul

¹Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet

|September 1, 2001

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A child with cerebral palsy presented with scurvy symptoms including purpuric rash and bleeding gums. Prompt vitamin C treatment resolved these signs, highlighting scurvy

Area of Science:

Pediatrics
Nutritional Deficiencies
Dermatology

Background:

Cerebral palsy (CP) can impact nutrition and mobility, potentially increasing risk for certain deficiencies.
Scurvy, a vitamin C deficiency, presents with a range of hematologic, cutaneous, and skeletal manifestations.

Observation:

An 8-year-old boy with CP exhibited progressive purpuric rash, bleeding gums, and extremity tenderness.
Physical exam revealed pallor, cachexia, petechiae, and follicular hyperkeratosis.
Radiographs showed generalized osteoporosis and metaphyseal abnormalities consistent with nutritional deficiency.

Findings:

Skin biopsy revealed dilated hair follicles with keratinous material and corkscrew hairs.
Laboratory results showed severe anemia (hemoglobin 6.6 g/dl) with normal platelet count and coagulogram.

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Diagnosis of scurvy was confirmed based on clinical, radiographic, and skin biopsy findings.

Implications:

This case underscores the importance of considering nutritional deficiencies, like scurvy, in children with cerebral palsy.
Early diagnosis and vitamin C supplementation are crucial for reversing the clinical and radiographic manifestations of scurvy.
Highlights the need for comprehensive nutritional assessment in neurologically impaired children.