Paediatric scurvy: frequently misdiagnosed

ABSTRACT

Paediatric scurvy is uncommon in the modern age but cases have been reported in children with neurodevelopmental issues and restricted dietary habits. The broad clinical picture is frequently overlooked as primarily other systemic diseases are considered first leading to extensive investigations and delay in diagnosis. A 4-year-old boy with autism and bilateral lower limb pain and refusal to walk is reported. His restricted diet and radiographic findings were highly suggestive of scurvy which was confirmed by the extremely low levels of ascorbic acid. Treatment with ascorbic acid replenishment and maintenance resulted in remarkable improvement. This case highlights the importance of a high index of suspicion in at-risk children so as to avoid unnecessary invasive investigations and procedures.

KEYWORDS:

• Scurvy
• vitamin C deficiency
• ascorbic acid
• autistic spectrum disorder

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

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Notes on contributors

Husna Musa

Husna Musa is a paediatrician and medical lecturer at the Department of Paediatrics, Faculty of Medicine and Health Science, Universiti Putra Malaysia. She has great interests in social paediatrics, child neurodevelopment and medical volunteerism.

Imma Isniza Ismail

Imma Isniza Ismail is an orthopaedic surgeon and medical lecturer at the Department of Orthopaedics, Faculty of Medicine and Health Science, Universiti Putra Malaysia. Her area of interests are paediatric orthopaedics, deformity correction and paediatric and adult limb lengthening and reconstruction surgery (LLRS).

Nurul Hazwani Abdul Rashid

Nurul Hazwani Abdul Rashid is a final year paediatric trainee for the Master of Medicine (Paediatrics) program, Universiti Putra Malaysia and currently working for the Ministry of Health, Malaysia.