"What can you C in a limping child?" Scurvy in an otherwise healthy "picky eater"

Khulud Diab Shehade1, Ron Lamdan2, Dvora Aharoni3

  • 1Department of Pediatrics, Assuta Ashdod Hospital, Ashdod, Israel.

Insights

Scurvy, a vitamin C deficiency, can affect healthy children with poor diets. This case highlights the need for nutritional assessment beyond growth charts to ensure adequate vitamin C intake.

Area of Science:

  • Pediatrics
  • Nutrition
  • Metabolic Bone Disease

Background:

  • Scurvy, historically associated with nutritional deficiencies, is rarely seen in developed countries.
  • This case involves a healthy 3-year-old child presenting with symptoms mimicking other serious conditions.

Observation:

  • A 3-year-old presented with limping, bone pain, fatigue, and agitation.
  • Imaging suggested a metabolic bone disease, later identified as scurvy.
  • Dietary history revealed extreme picky eating with a diet solely of dairy pudding.

Findings:

  • Diagnosis confirmed by critically low vitamin C levels.
  • Magnetic resonance imaging findings were consistent with scurvy.
  • Rapid recovery followed intravenous vitamin C administration.

Implications:

  • Scurvy can occur in healthy children due to highly restrictive diets.
  • Highlights the importance of detailed nutritional history in pediatric cases.
  • Standard growth charts may not suffice for identifying nutritional deficiencies.

Related Concept Videos

Bone Disorders01:29

Bone Disorders

Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
4.9K
Vitamins01:30

Vitamins

Vitamins, derived from the Latin word for life, are essential organic substances required in small quantities for optimal growth and overall well-being. Unlike other organic nutrients, vitamins don't act as sources of energy or building materials but rather facilitate these nutrients' utilization by the body. Vitamins are predominantly coenzymes, assisting enzymes in specific chemical actions, like the oxidation of glucose for energy involving B vitamins. Most vitamins are not produced...
1.9K
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
284
Inborn Errors of Metabolism01:20

Inborn Errors of Metabolism

Phenylketonuria (PKU) is a protein metabolism disorder characterized by high blood levels of the amino acid phenylalanine. This results from a mutation in the gene responsible for phenylalanine hydroxylase, an enzyme that converts phenylalanine into tyrosine. When this enzyme is deficient, phenylalanine builds up in the blood, leading to symptoms such as vomiting, rashes, seizures, growth deficiency, and severe mental retardation. An early diagnosis and a diet restricting phenylalanine intake...
595
Overview of Protein Metabolism01:21

Overview of Protein Metabolism

Proteins are broken down into amino acids during digestion. Unlike fats and carbohydrates, which are stored for later use, proteins are not. Instead, amino acids are either used to produce ATP through oxidation or contribute to the creation of new proteins for the growth and repair of the body. Any surplus amino acids from the diet are converted into glucose or triglycerides rather than excreted.
Amino acids play various roles in the body once they are absorbed into cells. They are restructured...
3.1K
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy

Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
528