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[Scurvy in children]
S Fejji1, M A Mongalgi, S Boukthir
1Service de pédiatrie et d'explorations fonctionelles digestives, hôpital d'Enfants de Tunis, Jebbari Bab Saadoun.
Insights
Scurvy can present misleadingly in encephalopathic children, mimicking other bone conditions. Early diagnosis and ascorbic acid treatment are crucial for recovery.
Area of Science:
- Pediatrics
- Nutritional Science
- Radiology
Background:
- Scurvy, a vitamin C deficiency disease, is rare in developed countries.
- Encephalopathic children may have atypical presentations of nutritional deficiencies.
- Bone ultrasonography is an emerging tool for diagnosing pediatric bone abnormalities.
Observation:
- Two 3-year-old girls with encephalopathy presented with symptoms mimicking other bone diseases.
- One child underwent surgery for presumed osteomyelitis, while the other had bleeding and subperiosteal hemorrhage.
- Ultrasonography revealed periosteal cleavage, aiding in the diagnosis of scurvy.
Findings:
- Diagnosis of scurvy was confirmed by deficient diet, clinical signs, and ultrasonographic findings.
- Treatment with ascorbic acid (400 mg/d) resulted in complete resolution of symptoms.
- Bone ultrasonography can exhibit misleading features in scurvy, mimicking other conditions.
Implications:
- Highlights the importance of considering scurvy in encephalopathic children with bone abnormalities.
- Suggests ultrasonography can be a valuable tool for diagnosing scurvy, despite potential for misinterpretation.
- Recommends routine ascorbic acid supplementation for children with severe mental retardation and risk factors for nutritional deficiencies.
Abstract:
The authors report two cases of scurvy in two encephalopathic 3 year-old girls. The first case was misleading and was initially operated with the diagnosis of osteomyelitis. The second one presented with bleeding syndrome and subperiosteal hemorrhage. The diagnosis of scurvy was based upon deficient diet, clinical features, and periosteal cleavage at ultrasonographic evaluation. Treatment with ascorbic acid, 400 mg/d, led to a complete resolution of the clinical features. The authors emphasize the misleading features of scurvy at bone ultrasonographic evaluation and recommend a supplementation with ascorbic acid of children with severe mental retardation.