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Pediatric Scurvy: When Contemporary Eating Habits Bring Back the Past
Alice Brambilla1, Cristina Pizza1, Donatella Lasagni2
1Pediatric Department, University of Florence, Anna Meyer Children Hospital, Florence, Italy.
Insights
Vitamin C deficiency, or scurvy, can occur in children due to strict diets, even in developed countries. Early recognition through dietary history is crucial to avoid misdiagnosis and invasive procedures.
Area of Science:
- Nutrition Science
- Pediatric Medicine
- Clinical Case Study
Background:
- Vitamin C deficiency (scurvy) is rare in developed nations, often linked to underlying health issues.
- Chronic low dietary intake causes vascular fragility, poor bone formation, bleeding, and pain.
- Pediatric scurvy symptoms mimic serious conditions like osteomyelitis, leukemia, and tumors.
Abstract:
Vitamin C deficiency is anecdotal in developed countries, mainly associated with underling clinical morbidities as autism or neurological impairment. Chronic insufficient dietary supply is responsible for vascular fragility and impaired bone formation, resulting in gingival bleeding, petechial lesions, articular and bone pain or limb swelling. Children may present anorexia, irritability, failure to thrive, limping or refusal to walk. Accordingly, pediatric scurvy is frequently misdiagnosed with osteomyelitis, septic arthritis, bone and soft tissue tumor, leukemia, bleeding disorders, and rheumatologic conditions. We report the case of a 3-years old child developing scurvy as consequence of strict selective diet; extensive and invasive investigations were undertaken before the correct diagnosis was considered. Despite being considered a rare condition, scurvy still exists nowadays, even in children with no apparent risk factors living in wealthy families. The increasing popularity of dietary restriction for children, especially those with allergies, may potentially enhance the occurrence of scurvy in apparently healthy children. Appropriate dietary anamnesis is fundamental in order to highlight potential nutritional deficit and to avoid unnecessary invasive diagnostic procedures. Patients without considerable risk factors may benefit from psychological support in order to investigate possible eating disorders.
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