Scurvy in pediatric patients: a review of 28 cases.
OBJECTIVE
To study the dietary factors, clinical findings, plasma vitamin C level and post-treatment outcome of scurvy in pediatric patients at Queen Sirikit National Institute of Child Health.


METHODS
A retrospective study.


METHODS
The medical and radiographic records of pediatric patients, diagnosed with scurvy at Queen Sirikit National Institute of Child Health from 1995 to 2002 were reviewed.


RESULTS
Twenty-eight pediatric patients were diagnosed with scurvy. Their ages ranged between 10 months-9 years 7 months (median age of 29 months). 93 per cent of the cases were between 1-4 years of age. All were fed with well-cooked foods and small amounts or no vegetables and fruits. Supplementation with ultra heat temperature (UHT) milk was found in 89 per cent, average 5.8 boxes/day and 14.3 months in duration. Eighty-six per cent of cases were misdiagnosed previously. Clinical manifestations involved limp or inability to walk (96%), tenderness of lower limbs (86%), bleeding per gum (36%), fever (18%), and petechial hemorrhage (3.6%). All cases had abnormal radiographic findings compatible with scurvy and 2 cases had epiphyseal separation. All had clinical improvement within the first week after vitamin C supplementation.


CONCLUSIONS
Vitamin C deficiency was found in the children's intake of small amounts or no vegetables and fruits together with UHT-milk. Frequent manifestations were limping and inability to walk and pain in the lower limbs. Response to vitamin C treatment was dramatic.
Ratanachu-Ek
Suntaree
S
Department of Pediatrics, Queen Sirikit National Institute of Child Health, Bangkok 10400, Thailand.
Sukswai
Pisit
P
Jeerathanyasakun
Yongyot
Y
Wongtapradit
Lawan
L
D001205:Ascorbic Acid / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012614:Scurvy / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D013785:Thailand / Q000453:epidemiology
D001205:Ascorbic Acid