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Scurvy presenting with limp and weakness: a case report

BACKGROUND: Scurvy is one of the oldest diseases known to mankind. Although presently rare in the developed world, scurvy was a common potentially fatal disease. In recent times, the most common risk factors for scurvy include alcoholism, low socioeconomic status, and severely poor nutrition or diet...

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Autores principales: Lund, Robin M., Becker, Mara L., Shapiro, Steven, Allison, Tyler, Harris, Julia G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6612164/
https://www.ncbi.nlm.nih.gov/pubmed/31279337
http://dx.doi.org/10.1186/s12887-019-1605-5
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author Lund, Robin M.
Becker, Mara L.
Shapiro, Steven
Allison, Tyler
Harris, Julia G.
author_facet Lund, Robin M.
Becker, Mara L.
Shapiro, Steven
Allison, Tyler
Harris, Julia G.
author_sort Lund, Robin M.
collection PubMed
description BACKGROUND: Scurvy is one of the oldest diseases known to mankind. Although presently rare in the developed world, scurvy was a common potentially fatal disease. In recent times, the most common risk factors for scurvy include alcoholism, low socioeconomic status, and severely poor nutrition or dietary restriction secondary to psychiatric illness or developmental disorders. Our case demonstrates the importance of having a high index of clinical suspicion of an uncommon disease in developed countries and emphasizes the necessity of a dietary screening that could potentially reduce extensive work-up in patients with nonspecific complaints. CASE PRESENTATION: We report a case of a 3-year-old previously healthy female originally seen in the rheumatology clinic for limp. She developed weakness and was admitted to the hospital for further evaluation. She underwent extensive diagnostic testing including blood work, magnetic resonance imaging, lumbar puncture, electromyogram, and nerve conduction studies. Ultimately, her vitamin C level returned undetectable. She had immediate and complete improvement upon starting vitamin C supplementation. CONCLUSIONS: Despite being developmentally appropriate, our patient’s refusal to eat fruits or vegetables had limited her diet, emphasizing the importance of obtaining a diet history in a child presenting with an unknown diagnosis. In addition, our patient had no other characteristic features of scurvy, which further supports the need to consider this diagnosis in a child presenting with lower extremity weakness or abnormal gait.
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spelling pubmed-66121642019-07-16 Scurvy presenting with limp and weakness: a case report Lund, Robin M. Becker, Mara L. Shapiro, Steven Allison, Tyler Harris, Julia G. BMC Pediatr Case Report BACKGROUND: Scurvy is one of the oldest diseases known to mankind. Although presently rare in the developed world, scurvy was a common potentially fatal disease. In recent times, the most common risk factors for scurvy include alcoholism, low socioeconomic status, and severely poor nutrition or dietary restriction secondary to psychiatric illness or developmental disorders. Our case demonstrates the importance of having a high index of clinical suspicion of an uncommon disease in developed countries and emphasizes the necessity of a dietary screening that could potentially reduce extensive work-up in patients with nonspecific complaints. CASE PRESENTATION: We report a case of a 3-year-old previously healthy female originally seen in the rheumatology clinic for limp. She developed weakness and was admitted to the hospital for further evaluation. She underwent extensive diagnostic testing including blood work, magnetic resonance imaging, lumbar puncture, electromyogram, and nerve conduction studies. Ultimately, her vitamin C level returned undetectable. She had immediate and complete improvement upon starting vitamin C supplementation. CONCLUSIONS: Despite being developmentally appropriate, our patient’s refusal to eat fruits or vegetables had limited her diet, emphasizing the importance of obtaining a diet history in a child presenting with an unknown diagnosis. In addition, our patient had no other characteristic features of scurvy, which further supports the need to consider this diagnosis in a child presenting with lower extremity weakness or abnormal gait. BioMed Central 2019-07-06 /pmc/articles/PMC6612164/ /pubmed/31279337 http://dx.doi.org/10.1186/s12887-019-1605-5 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Lund, Robin M.
Becker, Mara L.
Shapiro, Steven
Allison, Tyler
Harris, Julia G.
Scurvy presenting with limp and weakness: a case report
title Scurvy presenting with limp and weakness: a case report
title_full Scurvy presenting with limp and weakness: a case report
title_fullStr Scurvy presenting with limp and weakness: a case report
title_full_unstemmed Scurvy presenting with limp and weakness: a case report
title_short Scurvy presenting with limp and weakness: a case report
title_sort scurvy presenting with limp and weakness: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6612164/
https://www.ncbi.nlm.nih.gov/pubmed/31279337
http://dx.doi.org/10.1186/s12887-019-1605-5
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