Scurvy revealed by difficulty walking: Three cases in young children

Maleewan Kitcharoensakkul, Christa G. Schulz, Rachel Kassel, Geetika Khanna, Shannon Liang, Alexander Ngwube, Kevin W. Baszis, David A. Hunstad, Andrew J. White

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Scurvy is rare in developed countries but is known to cause lower-extremity pain and refusal to ambulate in children. Since the discovery of the link between scurvy and dietary deficiency of ascorbic acid, there has been a substantial decrease in its prevalence and recognition. Here we describe 3 cases of scurvy in young children presenting with difficulty walking. Only 1 of 3 patients had gingival lesions at the initial presentation. Two cases underwent an extensive evaluation for hematologic and rheumatologic diseases before the diagnosis of scurvy was made. Dietary histories eventually revealed that all 3 patients had sharply limited intake of fruits and vegetables secondary to oral aversion, and 1 patient had autism. Radiographic changes of long bones were observed in all patients. Interestingly, all patients had concomitant vitamin D deficiency. After replacement with vitamin C, all patients recovered and started to walk again with improved leg pain. These clinical manifestations and radiologic findings highlight the importance for rheumatologists to have a higher index of suspicion for scurvy in nonambulatory children.

Original languageEnglish (US)
Pages (from-to)224-228
Number of pages5
JournalJournal of Clinical Rheumatology
Volume20
Issue number4
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Scurvy
Mobility Limitation
Ascorbic Acid Deficiency
Pain
Vitamin D Deficiency
Hematologic Diseases
Autistic Disorder
Developed Countries
Vegetables
Ascorbic Acid
Lower Extremity
Fruit
Leg
Bone and Bones

Keywords

  • oral aversion
  • osteomyelitis
  • scurvy

ASJC Scopus subject areas

  • Rheumatology

Cite this

Kitcharoensakkul, M., Schulz, C. G., Kassel, R., Khanna, G., Liang, S., Ngwube, A., ... White, A. J. (2014). Scurvy revealed by difficulty walking: Three cases in young children. Journal of Clinical Rheumatology, 20(4), 224-228. https://doi.org/10.1097/RHU.0000000000000101

Scurvy revealed by difficulty walking : Three cases in young children. / Kitcharoensakkul, Maleewan; Schulz, Christa G.; Kassel, Rachel; Khanna, Geetika; Liang, Shannon; Ngwube, Alexander; Baszis, Kevin W.; Hunstad, David A.; White, Andrew J.

In: Journal of Clinical Rheumatology, Vol. 20, No. 4, 01.01.2014, p. 224-228.

Research output: Contribution to journalArticle

Kitcharoensakkul, M, Schulz, CG, Kassel, R, Khanna, G, Liang, S, Ngwube, A, Baszis, KW, Hunstad, DA & White, AJ 2014, 'Scurvy revealed by difficulty walking: Three cases in young children', Journal of Clinical Rheumatology, vol. 20, no. 4, pp. 224-228. https://doi.org/10.1097/RHU.0000000000000101
Kitcharoensakkul, Maleewan ; Schulz, Christa G. ; Kassel, Rachel ; Khanna, Geetika ; Liang, Shannon ; Ngwube, Alexander ; Baszis, Kevin W. ; Hunstad, David A. ; White, Andrew J. / Scurvy revealed by difficulty walking : Three cases in young children. In: Journal of Clinical Rheumatology. 2014 ; Vol. 20, No. 4. pp. 224-228.
@article{dce08f47b76b4bf0b7059183283229ec,
title = "Scurvy revealed by difficulty walking: Three cases in young children",
abstract = "Scurvy is rare in developed countries but is known to cause lower-extremity pain and refusal to ambulate in children. Since the discovery of the link between scurvy and dietary deficiency of ascorbic acid, there has been a substantial decrease in its prevalence and recognition. Here we describe 3 cases of scurvy in young children presenting with difficulty walking. Only 1 of 3 patients had gingival lesions at the initial presentation. Two cases underwent an extensive evaluation for hematologic and rheumatologic diseases before the diagnosis of scurvy was made. Dietary histories eventually revealed that all 3 patients had sharply limited intake of fruits and vegetables secondary to oral aversion, and 1 patient had autism. Radiographic changes of long bones were observed in all patients. Interestingly, all patients had concomitant vitamin D deficiency. After replacement with vitamin C, all patients recovered and started to walk again with improved leg pain. These clinical manifestations and radiologic findings highlight the importance for rheumatologists to have a higher index of suspicion for scurvy in nonambulatory children.",
keywords = "oral aversion, osteomyelitis, scurvy",
author = "Maleewan Kitcharoensakkul and Schulz, {Christa G.} and Rachel Kassel and Geetika Khanna and Shannon Liang and Alexander Ngwube and Baszis, {Kevin W.} and Hunstad, {David A.} and White, {Andrew J.}",
year = "2014",
month = "1",
day = "1",
doi = "10.1097/RHU.0000000000000101",
language = "English (US)",
volume = "20",
pages = "224--228",
journal = "Journal of Clinical Rheumatology",
issn = "1076-1608",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Scurvy revealed by difficulty walking

T2 - Three cases in young children

AU - Kitcharoensakkul, Maleewan

AU - Schulz, Christa G.

AU - Kassel, Rachel

AU - Khanna, Geetika

AU - Liang, Shannon

AU - Ngwube, Alexander

AU - Baszis, Kevin W.

AU - Hunstad, David A.

AU - White, Andrew J.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Scurvy is rare in developed countries but is known to cause lower-extremity pain and refusal to ambulate in children. Since the discovery of the link between scurvy and dietary deficiency of ascorbic acid, there has been a substantial decrease in its prevalence and recognition. Here we describe 3 cases of scurvy in young children presenting with difficulty walking. Only 1 of 3 patients had gingival lesions at the initial presentation. Two cases underwent an extensive evaluation for hematologic and rheumatologic diseases before the diagnosis of scurvy was made. Dietary histories eventually revealed that all 3 patients had sharply limited intake of fruits and vegetables secondary to oral aversion, and 1 patient had autism. Radiographic changes of long bones were observed in all patients. Interestingly, all patients had concomitant vitamin D deficiency. After replacement with vitamin C, all patients recovered and started to walk again with improved leg pain. These clinical manifestations and radiologic findings highlight the importance for rheumatologists to have a higher index of suspicion for scurvy in nonambulatory children.

AB - Scurvy is rare in developed countries but is known to cause lower-extremity pain and refusal to ambulate in children. Since the discovery of the link between scurvy and dietary deficiency of ascorbic acid, there has been a substantial decrease in its prevalence and recognition. Here we describe 3 cases of scurvy in young children presenting with difficulty walking. Only 1 of 3 patients had gingival lesions at the initial presentation. Two cases underwent an extensive evaluation for hematologic and rheumatologic diseases before the diagnosis of scurvy was made. Dietary histories eventually revealed that all 3 patients had sharply limited intake of fruits and vegetables secondary to oral aversion, and 1 patient had autism. Radiographic changes of long bones were observed in all patients. Interestingly, all patients had concomitant vitamin D deficiency. After replacement with vitamin C, all patients recovered and started to walk again with improved leg pain. These clinical manifestations and radiologic findings highlight the importance for rheumatologists to have a higher index of suspicion for scurvy in nonambulatory children.

KW - oral aversion

KW - osteomyelitis

KW - scurvy

UR - http://www.scopus.com/inward/record.url?scp=84901794325&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84901794325&partnerID=8YFLogxK

U2 - 10.1097/RHU.0000000000000101

DO - 10.1097/RHU.0000000000000101

M3 - Article

C2 - 24847751

AN - SCOPUS:84901794325

VL - 20

SP - 224

EP - 228

JO - Journal of Clinical Rheumatology

JF - Journal of Clinical Rheumatology

SN - 1076-1608

IS - 4

ER -