title: [Eat a citrus fruit, stay healthy--a case report of scurvy].
abstract: Scurvy is a disease that results from a vitamin C deficient diet. Since vitamin C is available in many food products, and especially in citrus fruits, the disease is rare in developed countries. Clinical manifestations of scurvy include general weakness, cutaneous and gum bleeding, pain in the lower limbs and inability to stand and walk (pseudo paralysis). The diagnosis of scurvy requires a high level of clinical suspicion, typical radiographic features and low Levels of vitamin C in the plasma. We report a case of a 7-year-old patient with a medical history of hydrocephalus, failure to thrive and severe psychomotor retardation due to complications of prematurity. On admission she had gum bleeding, severe anemia, pain in the lower limbs and refused to stand and walk. According to her parents, her diet was restricted, without vegetables or fruit consumption. Our investigation ruled out coagulopathy, malignancy and infection. Serum vitamin C levels were low and radiographic findings were consistent with the diagnosis of scurvy. The patient improved rapidly after the initiation of vitamin C supplements. Despite being rare, scurvy should be considered in the differential diagnosis of bleeding and pain in the lower limbs, especially in a malnourished patient.
authors.affiliation: Pediatric Ward, The Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel. shalomb2@clalit.org.il
authors.forename: Shalom
authors.initials: S
authors.lastname: Ben-Shimol
authors.forename: David
authors.initials: D
authors.lastname: Greenberg
mesh_terms: D000740:Anemia / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D001205:Ascorbic Acid / Q000008:administration & dosage / Q000097:blood; D001803:Blood Transfusion; D002648:Child; D015362:Child Nutrition Disorders / Q000150:complications / Q000378:metabolism / Q000523:psychology; D002957:Citrus; D002658:Developmental Disabilities / Q000150:complications*; D004750:Enteral Nutrition; D005183:Failure to Thrive / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D005884:Gingival Hemorrhage / Q000209:etiology; D006801:Humans; D007262:Infusions, Intravenous; D051346:Mobility Limitation; D059352:Musculoskeletal Pain / Q000000981:diagnostic imaging / Q000209:etiology; D008517:Phytotherapy; D011859:Radiography; D012614:Scurvy / Q000097:blood / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D001205:Ascorbic Acid