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Scurvy revealed by difficulty walking: three cases in young children.
J Clin Rheumatol 2014; 20(4):224-8JC

Abstract

Scurvy is rare in developed countries but is known to cause lower-extremity pain and refusal to ambulate in children. Since the discovery of the link between scurvy and dietary deficiency of ascorbic acid, there has been a substantial decrease in its prevalence and recognition. Here we describe 3 cases of scurvy in young children presenting with difficulty walking. Only 1 of 3 patients had gingival lesions at the initial presentation. Two cases underwent an extensive evaluation for hematologic and rheumatologic diseases before the diagnosis of scurvy was made. Dietary histories eventually revealed that all 3 patients had sharply limited intake of fruits and vegetables secondary to oral aversion, and 1 patient had autism. Radiographic changes of long bones were observed in all patients. Interestingly, all patients had concomitant vitamin D deficiency. After replacement with vitamin C, all patients recovered and started to walk again with improved leg pain. These clinical manifestations and radiologic findings highlight the importance for rheumatologists to have a higher index of suspicion for scurvy in nonambulatory children.

Authors+Show Affiliations

From the Departments of *Pediatrics and †Radiology, Washington University School of Medicine, St Louis, MO.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

24847751

Citation

Kitcharoensakkul, Maleewan, et al. "Scurvy Revealed By Difficulty Walking: Three Cases in Young Children." Journal of Clinical Rheumatology : Practical Reports On Rheumatic & Musculoskeletal Diseases, vol. 20, no. 4, 2014, pp. 224-8.
Kitcharoensakkul M, Schulz CG, Kassel R, et al. Scurvy revealed by difficulty walking: three cases in young children. J Clin Rheumatol. 2014;20(4):224-8.
Kitcharoensakkul, M., Schulz, C. G., Kassel, R., Khanna, G., Liang, S., Ngwube, A., ... White, A. J. (2014). Scurvy revealed by difficulty walking: three cases in young children. Journal of Clinical Rheumatology : Practical Reports On Rheumatic & Musculoskeletal Diseases, 20(4), pp. 224-8. doi:10.1097/RHU.0000000000000101.
Kitcharoensakkul M, et al. Scurvy Revealed By Difficulty Walking: Three Cases in Young Children. J Clin Rheumatol. 2014;20(4):224-8. PubMed PMID: 24847751.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Scurvy revealed by difficulty walking: three cases in young children. AU - Kitcharoensakkul,Maleewan, AU - Schulz,Christa G, AU - Kassel,Rachel, AU - Khanna,Geetika, AU - Liang,Shannon, AU - Ngwube,Alexander, AU - Baszis,Kevin W, AU - Hunstad,David A, AU - White,Andrew J, PY - 2014/5/23/entrez PY - 2014/5/23/pubmed PY - 2015/1/7/medline SP - 224 EP - 8 JF - Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases JO - J Clin Rheumatol VL - 20 IS - 4 N2 - Scurvy is rare in developed countries but is known to cause lower-extremity pain and refusal to ambulate in children. Since the discovery of the link between scurvy and dietary deficiency of ascorbic acid, there has been a substantial decrease in its prevalence and recognition. Here we describe 3 cases of scurvy in young children presenting with difficulty walking. Only 1 of 3 patients had gingival lesions at the initial presentation. Two cases underwent an extensive evaluation for hematologic and rheumatologic diseases before the diagnosis of scurvy was made. Dietary histories eventually revealed that all 3 patients had sharply limited intake of fruits and vegetables secondary to oral aversion, and 1 patient had autism. Radiographic changes of long bones were observed in all patients. Interestingly, all patients had concomitant vitamin D deficiency. After replacement with vitamin C, all patients recovered and started to walk again with improved leg pain. These clinical manifestations and radiologic findings highlight the importance for rheumatologists to have a higher index of suspicion for scurvy in nonambulatory children. SN - 1536-7355 UR - https://www.unboundmedicine.com/medline/citation/24847751/Scurvy_revealed_by_difficulty_walking:_three_cases_in_young_children_ L2 - http://Insights.ovid.com/pubmed?pmid=24847751 DB - PRIME DP - Unbound Medicine ER -