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Scurvy: an unusual complication of paediatric cancer treatment

Iain Irvine1, Triona Walshe2, Michael Capra3

  • 1Department of Radiology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland. irviner@tcd.ie.

Skeletal Radiology
|October 31, 2018
PubMed

Insights

Scurvy, a vitamin C deficiency disease, was diagnosed in a child with neuroblastoma despite adequate enteral vitamin C. Impaired absorption due to gastrointestinal issues caused the deficiency, highlighting the need for vigilance in at-risk patients.

Area of Science:

  • Pediatrics
  • Nutritional Science
  • Gastroenterology

Background:

  • Scurvy, historically linked to sailors, is a rare condition caused by vitamin C deficiency.
  • Modern medicine rarely encounters scurvy due to widespread vitamin C awareness.
  • This case explores an unusual presentation in a pediatric patient undergoing cancer treatment.

Observation:

  • A 2-year-old boy with neuroblastoma developed severe limb pain and tenderness during treatment.
  • Gastrointestinal complications necessitated enteral feeding, complicating his nutritional status.
  • Radiographic and biochemical findings confirmed scurvy, unexpectedly despite vitamin C supplementation.

Findings:

  • The patient's impaired absorption, due to pseudomembranous gastritis and enteritis, led to vitamin C deficiency.
  • Intravenous ascorbic acid replacement resulted in rapid clinical and radiological improvement.
  • This case underscores that adequate intake does not prevent deficiency if absorption is compromised.

Implications:

  • Scurvy should be considered in the differential diagnosis of limb pain in at-risk pediatric patients, including those with cancer and gastrointestinal issues.
  • Early diagnosis and treatment with ascorbic acid are crucial for preventing severe complications and ensuring full recovery.
  • This case emphasizes the importance of assessing nutrient absorption in patients with complex gastrointestinal conditions.

Keywords:
Enteral feedingNeuroblastomaScurvyVitamin C deficiency

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