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Case report
Scurvy: still a threat in the well-fed first world?
  1. Giulia Ceglie1,
  2. Giulia Macchiarulo1,
  3. Maria Rosaria Marchili2,
  4. Alessandra Marchesi2,
  5. Lelia Rotondi Aufiero2,
  6. Chiara Di Camillo2,
  7. Alberto Villani2
  1. 1 University Department of Pediatrics, Bambino Gesù Children’s Hospital, University of Rome Tor Vergata, Rome, Italy
  2. 2 General Pediatric and Infectious Disease Unit, University Department of Pediatrics, Bambino Gesù Children’s Hospital, Rome, Italy
  1. Correspondence to Dr Giulia Ceglie, University Department of Pediatrics, Bambino Gesù Children’s Hospital, University of Rome Tor Vergata, Rome 00165, Italy; giulia.ceglie{at}gmail.com

Abstract

We report three cases of scurvy in previously healthy children referred to us for leg pain and refusal to walk. All children had no significant medical history, symptoms had started months before and subtly advanced. Two of them presented with gingival hyperplasia and petechiae, another one reported night sweats and gingival bleeding in the past few weeks. Two had vitamin D deficiency, and all had microcytic anaemia (in one case requiring transfusional support). A nutritional screening revealed low or undetectable levels of ascorbic acid. This, along with the clinical and radiological findings, led to a diagnosis of scurvy. Vitamin C supplementation was started with rapid improvement of the children’s clinical condition. Scurvy is a rare disease in the ‘first world’, but there are anecdotal reports of scurvy in children without any of the known risk factors for this condition. In our cases, a selective diet was the only risk factor.

  • nutrition
  • obesity
  • collagen disorders
  • general paediatrics
  • growth

https://doi.org/10.1136/archdischild-2018-315496

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    Footnotes

    • Contributors GC and GM drafted the initial manuscript, and reviewed and revised the manuscript. MRM, AM, LRA and CDC collected data, reviewed and revised the manuscript. AV coordinated and supervised data collection and critically reviewed the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Parental/guardian consent obtained.

    • Ethics approval Comitato Etico dell’Opsedale Pediatrico Bambino Gesù (Ethics Committee of the Bambino Gesù Children Hospital).

    • Provenance and peer review Not commissioned; externally peer reviewed.