title: Severe vitamin C deficiency in a child newly diagnosed with T-cell ALL due to nutrient gap.
abstract: A 10-year-old boy developed a perifollicular rash during interim maintenance of T-Cell acute lymphoblastic leukaemia. Differential diagnoses included drug reaction and inflammatory process. Before diagnosis, the patient had a limited diet--low in vegetables and fruits--due to selective eating, with later anorexia and taste aversions due to chemotherapy treatment. Despite nutritional counselling and starting a multivitamin, the patient incurred severe weight loss (18.5% of his usual body weight). Serum levels of ascorbic acid were non-detectable, at <5 μmol/L, indicative of vitamin C deficiency. The patient began vitamin C supplementation containing 125 mg ascorbic acid three times a day for 7 days, then 125 mg once daily for 3 months to normalise serum vitamin C. After ascorbic acid treatment was completed, the patient started a complete multivitamin and made efforts to eat fruits and vegetables rich in vitamin C. His serum ascorbic acid concentrations normalised to 52 μmol/L 3 months after receiving supplementation.
authors.affiliation: Division of Pediatric Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
authors.forename: Sydney
authors.initials: S
authors.lastname: Harris-Janz
authors.affiliation: Division of Pediatric Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
authors.forename: Donna
authors.initials: D
authors.lastname: Johnston
authors.affiliation: Division of Pediatric Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Halton
mesh_terms: D001205:Ascorbic Acid / Q000008:administration & dosage*; D001206:Ascorbic Acid Deficiency / Q000178:diet therapy* / Q000209:etiology / Q000523:psychology; D002648:Child; D019587:Dietary Supplements; D037001:Directive Counseling / Q000379:methods; D002149:Energy Intake; D001068:Feeding and Eating Disorders / Q000178:diet therapy / Q000209:etiology / Q000523:psychology*; D005638:Fruit; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000523:psychology*; D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome; D014675:Vegetables; D014815:Vitamins / Q000008:administration & dosage*; D015431:Weight Loss
chemical_list: D014815:Vitamins; D001205:Ascorbic Acid
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