Scurvy presenting as difficulty in walking in a child

Area of Science:

• Nutrition
• Pediatrics
• Dermatology

Background:

• Scurvy, a condition resulting from ascorbic acid (vitamin C) deficiency, is infrequently encountered in contemporary medicine.
• Autism spectrum disorder (ASD) is often associated with food selectivity, potentially leading to nutritional deficiencies.

Observation:

• A middle childhood boy with autism presented with severe, progressive bilateral lower limb pain, lethargy, rashes, and bleeding gums.
• Physical examination revealed pathognomonic signs of scurvy, including ecchymoses, perifollicular hemorrhages, hyperkeratosis, and cockscrew hairs.
• A severely restricted diet was identified as the likely cause of the deficiency.

Findings:

• Low serum ascorbic acid levels confirmed the diagnosis of scurvy.
• Treatment with oral vitamin C supplementation and multidisciplinary rehabilitation resulted in complete symptom resolution.

Implications:

• This case highlights the critical need for comprehensive dietary assessments in children with autism and food selectivity, especially when presenting with non-specific symptoms.
• Increased physician awareness of nutritional deficiencies can prevent extensive investigations and reduce healthcare costs.
• Early identification and management of vitamin C deficiency are crucial for favorable outcomes in pediatric patients.