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回避限制型食物摄入障碍与一抹青柠——解开一例小儿坏血病病例之谜

ARFID and a twist of lime- unravelling a case of paediatric scurvy.

作者信息

Qaiyum Amer Abdul, Salim Maliha, Abdelrehiem Mohammed, Royle Leanne, Maltby Sarah

机构信息

Sheffield Children's Hospital NHS Foundation Trust, Broomhall, Sheffield, GB, UK.

出版信息

Eur J Clin Nutr. 2025 May 25. doi: 10.1038/s41430-025-01634-w.

Abstract

Scurvy, considered an ancient disease, is now being seen in children with restricted nutritional intake. Often children have vague symptoms which warrant thorough investigations to rule out more serious causes. The diagnostic uncertainty, extensive investigations and prolonged hospitalization has significant impact on child's development. We have presented a case of scurvy in a 7-year-old boy, known to have ARFID with progressive lower limb pain, weakness, limp and inability to bear weight for 5 weeks which have previously been reported in literature. However, this case was complicated by variable neurological findings during his admission. Scurvy was considered and diagnosed much later in the disease course after ruling out more sinister causes. Main learning points of this case were to have a high index of suspicion for Scurvy in children with restricted intake, and to improve surveillance and monitoring for nutritional deficiencies in these patients.

摘要

坏血病虽被视为一种古老疾病,但如今在营养摄入受限的儿童中仍有出现。儿童通常有模糊的症状,这就需要进行全面检查以排除更严重的病因。诊断的不确定性、广泛的检查以及长期住院对儿童发育有重大影响。我们报告了一例7岁男孩患坏血病的病例,该男孩患有小儿进食障碍,渐进性下肢疼痛、无力、跛行且5周无法负重,此前文献已有报道。然而,该病例在入院期间伴有多种神经系统表现。在排除更险恶的病因后,坏血病在病程后期才被考虑并诊断出来。该病例的主要经验教训是,对于摄入受限的儿童要高度怀疑坏血病,并加强对这些患者营养缺乏情况的监测。

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