Ben-Shimol Shalom, Greenberg David
Pediatric Ward, The Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Harefuah. 2012 Jun;151(6):327-9, 380.
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.
坏血病是一种由饮食中缺乏维生素C引起的疾病。由于许多食品中都含有维生素C，尤其是柑橘类水果，因此这种疾病在发达国家较为罕见。坏血病的临床表现包括全身虚弱、皮肤和牙龈出血、下肢疼痛以及无法站立和行走（假性瘫痪）。坏血病的诊断需要高度的临床怀疑、典型的影像学特征以及血浆中维生素C水平较低。我们报告一例7岁患者，有脑积水病史，因早产并发症导致生长发育迟缓及严重精神运动发育迟缓。入院时她有牙龈出血、严重贫血、下肢疼痛，且拒绝站立和行走。据其父母称，她的饮食受限，不吃蔬菜和水果。我们的调查排除了凝血障碍、恶性肿瘤和感染。血清维生素C水平较低，影像学检查结果与坏血病的诊断一致。开始补充维生素C后，患者病情迅速好转。尽管坏血病很罕见，但在下肢出血和疼痛的鉴别诊断中应考虑到这种疾病，尤其是在营养不良的患者中。
