PAEDIATRIC SCURVY: OLD WINE IN NEW BOTTLES

¹M. A. Anjay, ²V. Palanivel, ¹R. Chaudhary, ¹R. Stocks. ¹James Paget University Hospital NHS Trust, Great Yarmouth, UK, ²Addenbrooke’s Hospital, Cambridge, UK

Scurvy as a paediatric disease of significant morbidity and mortality has been all but forgotten in most developed countries, including the UK. We present a case of scurvy, followed by a literature search for recent reports on scurvy and try to analyse these from a historical perspective.

Case report: A 6-year-old girl known to have cerebral palsy and hemiparesis presented with new-onset limping and painful swelling of the limbs. Subsequent evaluation revealed a poor diet, mild anaemia and some petechial spots. x-Ray and MRI studies demonstrated bone and soft tissue changes strongly suggestive of scurvy. There was dramatic response to vitamin C supplementation.

Literature search: A structured literature search was undertaken and all cases of scurvy reported from developed countries in the last 10 years were retrieved. The epidemiology of these cases was then analysed for any patterns and was then compared with historical descriptions.

Results and historical perspective: Classically, scurvy was first described in detail in sailors and the pioneering work by James Lind in this regard is well known. Towards the end of the 19th century, “infantile scurvy” was described, mostly in infants from affluent families who were given heated formula milk products. Subsequent changes in feeding practices and the fortification of milk products with vitamin C led to the virtual elimination …