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坏血病:儿童癌症治疗的一种罕见并发症。

Scurvy: an unusual complication of paediatric cancer treatment.

作者信息

Irvine Iain, Walshe Triona, Capra Michael, Hayes Roisin

机构信息

Department of Radiology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland.

Department of Oncology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland.

出版信息

Skeletal Radiol. 2019 Jun;48(6):995-998. doi: 10.1007/s00256-018-3103-5. Epub 2018 Oct 29.

Abstract

Scurvy is a disease that is rarely encountered in modern medicine. A condition that was classically associated with sailors, its incidence has decreased dramatically since the discovery of its association with vitamin C deficiency. We present the case of a 2-year-old boy, whose treatment for neuroblastoma was complicated by gastrointestinal disease, which necessitated enteral feeding. While still undergoing treatment, he started to complain about increasing pain in his lower limbs, which appeared to be markedly tender on palpation. Radiographic findings suggested a diagnosis of scurvy, which was subsequently confirmed on serum biochemistry. This was an unexpected finding, as the child had been receiving adequate vitamin C in his enteral feeds. However, his absorption had become severely impaired due to pseudomembranous gastritis and enteritis, leading to his deficient state. He significantly improved after intravenous ascorbic acid replacement and demonstrated a full recovery, both clinically and radiologically. This case highlights the importance of considering scurvy in the differential diagnosis for at-risk patients. Early recognition can facilitate the simple treatment of this potentially serious condition.

摘要

坏血病是现代医学中很少遇到的一种疾病。这种疾病传统上与水手有关,自从发现其与维生素C缺乏有关以来,其发病率已大幅下降。我们报告一例2岁男孩的病例,他因神经母细胞瘤接受治疗,并发胃肠道疾病,需要进行肠内喂养。在仍在接受治疗期间,他开始抱怨下肢疼痛加剧,触诊时明显压痛。影像学检查结果提示坏血病诊断,随后血清生化检查得以证实。这是一个意外发现,因为该患儿在肠内喂养中已摄入足够的维生素C。然而,由于假膜性胃炎和肠炎,他的吸收严重受损,导致维生素C缺乏状态。静脉补充维生素C后,他有显著改善,临床和影像学上均显示完全康复。该病例强调了在高危患者的鉴别诊断中考虑坏血病的重要性。早期识别有助于对这种潜在严重疾病进行简单治疗。

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