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儿童坏血病:沉默的伪装者。

Scurvy in Children: The Silent Masquerader.

机构信息

Department of Paediatrics, KIMSHEALTH, Trivandrum, Kerala, India.

出版信息

J Trop Pediatr. 2022 Apr 5;68(3). doi: 10.1093/tropej/fmac029.

Abstract

In modern society, scurvy is well known in its historical perspective rather than clinical relevance. Scurvy is classically thought to manifest with signs of 'bleeding painful gums' in the undernourished. Little is known regarding its ability to mimic a wide range of rheumatological, orthopaedic, neurological and haematological illnesses. Due to the rarity of its occurrence, there is a poor understanding among present-day clinicians, and so scurvy can easily deceive the uninitiated. We report a school-aged boy with normal neurodevelopment who presented with lower limb pain and difficulty in walking. He was seen by multiple specialist doctors before the clinical diagnosis of scurvy was made by a general paediatrician. Investigations showed that this child had X-ray changes typical of scurvy with low serum ascorbic acid levels. On supplementation with vitamin C, he showed dramatic improvement in symptoms and gradually achieved complete recovery.

摘要

在现代社会,坏血病从历史角度来看广为人知,而从临床相关性角度来看则不然。坏血病一般被认为表现为营养不良者的“出血性疼痛牙龈”。关于其模仿广泛的风湿、骨科、神经和血液疾病的能力,人们知之甚少。由于其发生的罕见性,当代临床医生对此了解甚少,因此坏血病很容易欺骗不了解情况的人。我们报告了一个神经发育正常的学龄男孩,他出现下肢疼痛和行走困难。他曾被多位专科医生看过,直到一位儿科全科医生做出坏血病的临床诊断。检查显示,该儿童的 X 射线变化具有坏血病的典型特征,血清抗坏血酸水平较低。补充维生素 C 后,他的症状明显改善,逐渐完全康复。

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