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Vitamin C Deficiency in Children: Clinical Characteristics, Testing Patterns and Management Outcomes at a Tertiary
Thomas McFinnegan1, Jennifer Anderson1, Jacqueline Dalby-Payne1,2
1The Children's Hospital at Westmead, Sydney, Australia.
Insights
Vitamin C deficiency is common in children, especially inpatients and those in oncology or renal care. Supplementation effectively improves vitamin C levels in deficient paediatric patients.
Area of Science:
- Pediatric Endocrinology
- Nutritional Science
- Clinical Chemistry
Background:
- Vitamin C deficiency, while preventable, can impact child health.
- Understanding prevalence and risk factors in a paediatric setting is crucial for timely intervention.
Purpose of the Study:
- To characterize vitamin C deficiency in a paediatric tertiary hospital cohort.
- To identify clinical features, management strategies, and outcomes.
Main Methods:
- Retrospective analysis of serum vitamin C tests (August 2020 - January 2023).
- Defined deficiency as <40 µmol/L; critical deficiency as ≤10 µmol/L.
- Analyzed demographics, indications, interventions, and follow-up using statistical methods.
Main Results:
- 25.2% of 1350 patients showed vitamin C deficiency; 5.4% were critically deficient.
- Higher rates observed in inpatients and older children; oncology and renal specialties had highest yields.
- Oral vitamin C supplementation improved levels in 90% of critically deficient patients with available follow-up.
Conclusions:
- Vitamin C deficiency is prevalent in this paediatric cohort.
- Enhanced clinical awareness, documentation, and follow-up are recommended to optimize care.
- Early detection and management lead to significant improvement in vitamin C levels.
Aim:
To determine the clinical characteristics and management outcomes of vitamin C deficiency in a paediatric tertiary hospital cohort.
Methods:
Retrospective review of all serum vitamin C tests from August 2020 to January 2023 at a tertiary paediatric centre. Vitamin C deficiency was defined as < 40 μmol/L, with ≤ 10 μmol/L as critically deficient. Demographics, clinical indications, interventions and follow-up results were analysed using descriptive statistics, chi-square tests, Mann-Whitney U tests and logistic regression.
Results:
From 1923 tests in 1350 patients (median age 8.4 years, 58.5% male), 25.2% were deficient (< 40 μmol/L) and 5.4% critically low (≤ 10 μmol/L). Inpatients and older children had higher deficiency rates (p < 0.001). Oncology and renal specialties demonstrated the highest deficiency yields. Age, inpatient status and oncology referrals independently predicted deficiency. Clinical indications included suspected scurvy symptoms (29%, deficiency yield 25.8%), routine screening (21%; yield 31.5%) and unclear reasons (49%; 22.2% yield). For patients with critical vitamin C deficiency (n = 86), oral vitamin C supplementation was most common (69%) and follow-up levels (available in 47%) showed improvement in 90%, with normalisation in 62.5%.
Conclusion:
Vitamin C deficiency was common in this paediatric cohort. Improved clinical vigilance, clearer documentation of test rationale and consistent follow-up practices could optimise outcomes for affected children.
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