Talarico V, Aloe M, Barreca M, Galati M C, Raiola G
Department of Pediatrics, University "Magna Graecia" of Catanzaro, Italy.
Departments of Pediatric, Pugliese-Ciaccio Hospital, Catanzaro, Italy.
Clin Ter. 2014;165(5):253-6. doi: 10.7417/CT.2014.1755.
Scurvy, a disease caused by a deficiency of ascorbic acid (vitamin C), is not very common disease especially in pediatric age. In the late nineteenth century, instead, we assisted to increase incidence of this problem for the use of heated milk and convenience foods. We report two cases of scurvy: a child of 3 years old came to our observation for an important gums' stomatitis, fever, widespread petechiae and ecchymosis on the skin of the lower limbs; in the second moment he had pain in upper and lower limbs with difficulty in walking; a second child of 4 years came to our observation for pain lower limbs and maintained the posture of the legs down, inability to walking, with reduced muscle tone and trophism in all limbs; at the instrumental examination he had an alveolar hemorrhage. The two boys had a history of a diet completely lacking in fruits and vegetables; they were drinking almost only milk. They carried various laboratory and instrumental tests, in particular X-ray of lower limbs that showed "a thick sclerotic metaphyseal line with beak-like excrescences of tibiae and femur". The characteristic radiological appearance, the particular clinical aspects, the dietary history and the dosage of vitamin C, have led us to the diagnosis of scurvy. They started therapy with vitamin C and they had a progressive improvement in general condition.
坏血病是一种由缺乏抗坏血酸（维生素C）引起的疾病，并不常见，尤其是在儿童时期。然而，在19世纪后期，由于使用加热牛奶和方便食品，我们发现这个问题的发病率有所上升。我们报告两例坏血病病例：一名3岁儿童因严重的牙龈口腔炎、发热、下肢皮肤广泛瘀点和瘀斑前来就诊；随后他出现上下肢疼痛，行走困难；另一名4岁儿童因下肢疼痛前来就诊，双腿呈下垂姿势，无法行走，四肢肌肉张力和营养状态降低；在检查中发现他有牙槽出血。这两个男孩都有完全缺乏水果和蔬菜的饮食史，几乎只喝牛奶。他们进行了各种实验室和检查，特别是下肢X线检查，显示“胫骨和股骨的干骺端有一条增厚的硬化线，伴有喙状赘生物”。典型的放射学表现、特殊的临床症状、饮食史以及维生素C的检测结果，使我们诊断为坏血病。他们开始接受维生素C治疗，总体状况逐渐改善。
