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Chronic Recurrent Multifocal Osteomyelitis Mimicking Scurvy in a Child: A Case Report
Rawan Alhalabi1, Basil Nasrallah1, Rizviya Rahman1
1Department of Pediatrics, American Hospital Dubai, Dubai, ARE.
Insights
Scurvy, a vitamin C deficiency, can mimic other conditions in children, presenting with non-specific symptoms. Early diagnosis and vitamin C treatment are crucial for rapid symptom resolution in pediatric cases.
Area of Science:
- Pediatrics
- Nutritional Science
- Radiology
Background:
- Scurvy, a rare condition due to vitamin C deficiency, presents with nonspecific symptoms, complicating diagnosis, especially in pediatric patients.
- Nutritional deficiencies can persist in certain populations despite advanced healthcare in Gulf countries.
Observation:
- A six-year-old boy experienced recurrent leg pain, initially suspected as chronic recurrent multifocal osteomyelitis (CRMO) based on clinical and imaging findings.
- Despite progressive symptoms, the patient's condition was ultimately attributed to scurvy.
Findings:
- Vitamin C supplementation led to rapid and complete resolution of the patient's symptoms.
- This case underscores the diagnostic challenge of scurvy in children presenting with multisystemic involvement.
Implications:
- Pediatricians, orthopedists, rheumatologists, and radiologists should include scurvy in their differential diagnoses for children with unexplained multisystemic symptoms.
- Raising awareness of scurvy is important, particularly in regions where nutritional deficiencies may be encountered.
- Prompt diagnosis and treatment of scurvy can prevent prolonged illness and misdiagnosis.
Abstract:
Scurvy is a rare clinical syndrome resulting from prolonged vitamin C deficiency and is uncommon in the Gulf area. It can present with non-specific symptoms, making diagnosis and treatment challenging. In pediatric patients, symptoms may include weight loss, lethargy, low-grade fever, anemia of varying degrees, easy bruising or bleeding, joint and muscle pain, and poor wound healing. Despite advances in healthcare in many Gulf countries, nutritional deficiencies can still occur in certain populations. Therefore, it is important for pediatricians, orthopedists, rheumatologists, and radiologists to consider scurvy in the evaluation of children with low-grade, multisystemic involvement. We report a case of a six-year-old boy who presented to the emergency department (ED) multiple times with progressive right (RT) leg pain. The clinical picture and imaging findings suggested chronic recurrent multifocal osteomyelitis (CRMO). Despite symptom progression, scurvy was ultimately diagnosed and treatment with vitamin C led to rapid resolution of his symptoms. This case highlights the importance of considering scurvy in the differential diagnosis of children with multisystemic involvement, especially in regions where nutritional deficiencies may be more prevalent.
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