title: Lost at Sea in Search of a Diagnosis: A Case of Unexplained Bleeding.
abstract: Scurvy results from a dietary deficiency of vitamin C (ascorbic acid) and is rarely thought of in modern day medicine. It now almost always occurs in pediatric patients with behavioral diagnoses, nutritionally restricted diets, and food allergies. Symptoms of scurvy include ecchymoses, bleeding gums, and arthralgias. Here, we present a 17-year-old male with autism spectrum disorder and a diet severely deficient in ascorbic acid due to textural aversion and food preferences. He presented with recurrent arthritis, hemarthrosis, bruising, and anemia. His vitamin C level was low, and his symptoms improved promptly after treatment with ascorbic acid.
authors.affiliation: Division of Hematology Oncology, Children's Mercy Hospital, Kansas City, Missouri.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Amos
authors.affiliation: Division of Hematology Oncology, Children's Mercy Hospital, Kansas City, Missouri.
authors.forename: Shannon L
authors.initials: SL
authors.lastname: Carpenter
authors.affiliation: Division of Pediatric Rheumatology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan.
authors.forename: Mark F
authors.initials: MF
authors.lastname: Hoeltzel
mesh_terms: D000293:Adolescent; D001205:Ascorbic Acid / Q000008:administration & dosage*; D000067877:Autism Spectrum Disorder; D006470:Hemorrhage / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008297:Male; D012614:Scurvy / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology
chemical_list: D001205:Ascorbic Acid
keywords: autism spectrum disorder; hemarthrosis; scurvy