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Do you remember scurvy?
V Talarico1, M Aloe1, M Barreca2
1Department of Pediatrics, University "Magna Graecia" of Catanzaro, Italy.
Insights
Scurvy, a vitamin C deficiency disease, is rare in children but was seen more in the late 19th century. This report details two pediatric cases highlighting the importance of a balanced diet for preventing this condition.
Area of Science:
- Pediatrics
- Nutritional Science
- Medical History
Background:
- Scurvy, a condition resulting from ascorbic acid (vitamin C) deficiency, is uncommon in pediatric populations.
- Historical context notes an increased incidence in the late 19th century due to processed foods and heated milk.
- This abstract focuses on two contemporary pediatric cases of scurvy.
Observation:
- Two children, aged 3 and 4 years, presented with distinct symptoms including severe gingivitis, fever, petechiae, ecchymosis, limb pain, and difficulty walking.
- Both patients exhibited reduced muscle tone and trophism, with one case presenting alveolar hemorrhage.
- A history of exclusive milk consumption and a diet devoid of fruits and vegetables was noted in both cases.
Findings:
- Radiological examination revealed characteristic "thick sclerotic metaphyseal lines with beak-like excrescences" in the tibiae and femurs of both children.
- Diagnosis was confirmed through clinical presentation, dietary history, laboratory tests, and vitamin C levels.
- The distinctive radiographic and clinical signs, coupled with dietary history, were crucial for diagnosing scurvy.
Implications:
- These cases underscore the continued relevance of scurvy, even in modern times, particularly with atypical diets.
- Prompt diagnosis and vitamin C supplementation led to significant clinical improvement in both pediatric patients.
- Highlights the critical role of a balanced diet rich in fruits and vegetables for preventing vitamin C deficiency in children.
Abstract:
Scurvy, a disease caused by a deficiency of ascorbic acid (vitamin C), is not very common disease especially in pediatric age. In the late nineteenth century, instead, we assisted to increase incidence of this problem for the use of heated milk and convenience foods. We report two cases of scurvy: a child of 3 years old came to our observation for an important gums' stomatitis, fever, widespread petechiae and ecchymosis on the skin of the lower limbs; in the second moment he had pain in upper and lower limbs with difficulty in walking; a second child of 4 years came to our observation for pain lower limbs and maintained the posture of the legs down, inability to walking, with reduced muscle tone and trophism in all limbs; at the instrumental examination he had an alveolar hemorrhage. The two boys had a history of a diet completely lacking in fruits and vegetables; they were drinking almost only milk. They carried various laboratory and instrumental tests, in particular X-ray of lower limbs that showed "a thick sclerotic metaphyseal line with beak-like excrescences of tibiae and femur". The characteristic radiological appearance, the particular clinical aspects, the dietary history and the dosage of vitamin C, have led us to the diagnosis of scurvy. They started therapy with vitamin C and they had a progressive improvement in general condition.
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