Departments of Pediatrics and.
Department of Pediatrics, NYU School of Medicine, New York, New York.
Pediatrics. 2019 Sep;144(3). doi: 10.1542/peds.2018-2824. Epub 2019 Aug 14.
Scurvy is a rare disease in developed nations. In the field of pediatrics, it primarily is seen in children with developmental and behavioral issues, malabsorptive processes, or diseases involving dysphagia. We present the case of an otherwise developmentally appropriate 4-year-old boy who developed scurvy after gradual self-restriction of his diet. He initially presented with a limp and a rash and was subsequently found to have anemia and hematuria. A serum vitamin C level was undetectable, and after review of the MRI of his lower extremities, the clinical findings supported a diagnosis of scurvy. Although scurvy is rare in developed nations, this diagnosis should be considered in a patient with the clinical constellation of lower-extremity pain or arthralgias, a nonblanching rash, easy bleeding or bruising, fatigue, and anemia. This case highlights the importance of carefully assessing a child's dietary and developmental status at well-child visits, which can help avoid a more invasive workup.
坏血病在发达国家较为罕见。在儿科领域，其主要见于存在发育和行为问题、吸收不良或吞咽困难相关疾病的儿童。我们报告了 1 例表现为逐渐节食且发育正常的 4 岁男孩发生坏血病的病例。他最初表现为跛行和皮疹，随后发现存在贫血和血尿。血清维生素 C 水平无法检测到，下肢 MRI 检查后，临床发现支持坏血病的诊断。尽管坏血病在发达国家较为罕见，但对于出现下肢疼痛或关节痛、非压之退色皮疹、容易出血或瘀伤、疲劳和贫血的患者，应考虑该诊断。本病例强调了在儿童常规就诊时仔细评估其饮食和发育状况的重要性，这有助于避免更具侵袭性的检查。
