van Heerden Carolyn, Cheng Daryl R, McNab Sarah, Burgess Rosemary, Russell Ashleigh, Wang Yichun, Bleathman Freya, Maharaj Isabella, Zhang Jerry, Easterbrook Marley, Papadopulos Marie, Ibrahim Laila F
Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.
Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
J Paediatr Child Health. 2024 Sep;60(9):409-414. doi: 10.1111/jpc.16594. Epub 2024 Jun 21.
We aimed to investigate the frequency of vitamin C deficiency scurvy in the Australian paediatric context, describe cohorts at risk, and identify factors associated with development of symptoms in children with vitamin C deficiency. We also aimed to propose a management guideline for children with features of scurvy.
A retrospective study was done at a tertiary paediatric hospital in Australia over a three-year period, from August 2019 to July 2022. Children from birth to 18 years old, whose vitamin C levels were low (<23 μmol/L), were included. Data extracted from hospital medical records included demographics, weight, co-morbidities, eating disorder diagnoses, clinical features, investigations and treatment. Descriptive statistics and risk statistics were performed.
In a cohort of 887 patients who had their vitamin C levels checked, we identified 272 (31%) who had a vitamin C level <23 μmol/L. Of these, 13 (5%) were symptomatic of vitamin C deficiency and 19 (7%) may have been symptomatic. In patients with vitamin C deficiency, 248 (91%) had comorbidities, neurodevelopmental disorders being most common, and 176 (65%) had restricted eating. When the asymptomatic and symptomatic groups were compared, in the symptomatic group, there was a significantly lower vitamin C level and disordered eating related to autism spectrum disorders was more common.
In order to avoid delayed diagnoses and unnecessary investigations, clinicians should be familiar with symptoms of scurvy and perform a dietary assessment, vitamin C assay, and commence empiric vitamin C supplementation where appropriate.
我们旨在调查澳大利亚儿科环境中维生素C缺乏性坏血病的发生率，描述高危人群，并确定维生素C缺乏儿童出现症状的相关因素。我们还旨在为有坏血病特征的儿童提出管理指南。
在澳大利亚一家三级儿科医院进行了一项为期三年的回顾性研究，时间从2019年8月至2022年7月。纳入出生至18岁维生素C水平低（<23μmol/L）的儿童。从医院病历中提取的数据包括人口统计学、体重、合并症、饮食失调诊断、临床特征、检查和治疗。进行了描述性统计和风险统计。
在887名接受维生素C水平检查的患者队列中，我们确定了272名（31%）维生素C水平<23μmol/L的患者。其中，13名（5%）有维生素C缺乏症状，19名（7%）可能有症状。在维生素C缺乏的患者中，248名（91%）有合并症，神经发育障碍最为常见，176名（65%）饮食受限。比较无症状组和有症状组时，有症状组的维生素C水平显著较低，与自闭症谱系障碍相关的饮食失调更为常见。
为避免诊断延迟和不必要的检查，临床医生应熟悉坏血病的症状，进行饮食评估、维生素C检测，并在适当情况下开始经验性补充维生素C。
