title: Arthritis and gum bleeding in two children.
abstract: In developed countries, scurvey is quite rare and can be seen in children with severely restricted diets, related to psychiatric or developmental problems. Clinical presentation can include arthralgias/arthritis, myalgias, hemarthrosis, purpura and ecchymosis. We report two cases of nutritional vitamin C deficiency, who have been misdiagnosed as having rheumatologic diseases, and promptly resolved with vitamin C treatment. Both patents did not have the classic radiological features described in scurvey, such as the Wimberger ring or the white lines of Frankel. Magnetic resonance imaging clearly showed areas of hemorrhage at bony and subperiasteal level. This imaging procedure, therefore, should be recommended especially in the doubtful cases. The two patients described herein should alert pediatricians to consider scurvey although rare, as a potential source of "rheumatological" manifestations in children, especially in the industrialized countries where in appropriate vitamin intake is often underestimated.
authors.affiliation: Department of Paediatrics, Rheumatology Unit, University of Messina, Messina, Italy. vitale@interfree.it
authors.forename: Agata
authors.initials: A
authors.lastname: Vitale
authors.forename: Francesco
authors.initials: F
authors.lastname: La Torre
authors.forename: Giorgia
authors.initials: G
authors.lastname: Martini
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Calcagno
authors.forename: Carmelo
authors.initials: C
authors.lastname: Fede
authors.forename: Giovanni
authors.initials: G
authors.lastname: Conti
authors.forename: Roberto
authors.initials: R
authors.lastname: Chimenz
authors.forename: Francesco
authors.initials: F
authors.lastname: Zulian