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Scurvy in a Child Presenting With a Limp and Elevated Inflammatory Markers: A Case Report
Dan Rittenhouse1, Alexander Daly2
1Pediatrics, Penn State College of Medicine, Hershey, USA.
Insights
Scurvy, a vitamin C deficiency, can occur in children with autism spectrum disorder due to selective eating. Early diagnosis and vitamin C treatment significantly improved this child's mobility.
Area of Science:
- Pediatrics
- Nutritional Science
- Clinical Medicine
Background:
- Scurvy is uncommon in developed nations but recognized in pediatric populations with specific risk factors.
- Micronutrient deficiencies, including vitamin C deficiency, are concerns in children with autism spectrum disorder, developmental delay, and eating disorders.
Observation:
- A seven-year-old female with autism spectrum disorder presented with a limp, refusal to walk, and elevated inflammatory markers.
- The patient exhibited a highly selective diet and signs of malnutrition.
Findings:
- A provisional diagnosis of scurvy was made based on clinical presentation and dietary history.
- Treatment with high-dose vitamin C rapidly improved the patient's ambulatory function.
- Initial plasma vitamin C levels were undetectable, confirming severe deficiency.
Implications:
- This case highlights the importance of considering scurvy in pediatric patients with autism spectrum disorder and selective eating habits.
- Prompt diagnosis and vitamin C supplementation are crucial for reversing symptoms and improving outcomes.
- Multidisciplinary care, including feeding therapy, is essential for managing malnutrition and selective eating in at-risk children.
Abstract:
Scurvy is a rare diagnosis in resource-rich countries, but cases have been documented in the United States in special populations of pediatric patients at increased risk of micronutrient deficiency such as those with autism spectrum disorder, developmental delay, or eating disorders. We discuss a seven-year-old female with autism spectrum disorder who presented with a limp and refusal to ambulate and elevated inflammatory markers on initial laboratory evaluation. Given her highly selective diet and malnutrition, we made a provisional diagnosis of scurvy and started treatment-dose vitamin C, which led to a significant improvement in her ambulatory function. Plasma vitamin C was ultimately undetectable. She was discharged with vitamin C supplementation and referred to a feeding clinic to address her malnutrition and selective eating.
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