ARFID and a twist of lime- unravelling a case of paediatric scurvy

Scurvy, considered an ancient disease, is now being seen in children with restricted nutritional intake. Often children have vague symptoms which warrant thorough investigations to rule out more serious causes. The diagnostic uncertainty, extensive investigations and prolonged hospitalization has significant impact on child's development. We have presented a case of scurvy in a 7-year-old boy, known to have ARFID with progressive lower limb pain, weakness, limp and inability to bear weight for 5 weeks which have previously been reported in literature. However, this case was complicated by variable neurological findings during his admission. Scurvy was considered and diagnosed much later in the disease course after ruling out more sinister causes. Main learning points of this case were to have a high index of suspicion for Scurvy in children with restricted intake, and to improve surveillance and monitoring for nutritional deficiencies in these patients.