Toscano Fabio, Zirilli Giuseppina, Randazzese Simone Foti, Carlino Mariagrazia, Gallizzi Romina, Wasniewska Malgorzata, Valenzise Mariella
Department of Human Pathology of Adulthood and Childhood "G. Barresi", Pediatric Unit, University of Messina, Messina, Italy.
Pediatric Unit, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy.
Ital J Pediatr. 2025 May 28;51(1):159. doi: 10.1186/s13052-025-02014-7.
In the recent past an incremental incidence of scurvy has been reported in the pediatric population, especially in children with neuropsychiatric disorders and a selective diet. Musculoskeletal manifestations, such as limp and refusal to walk, usually represent the main causes of access in the emergency room. Nowadays, new patterns of manifestations have been demonstrated, such as hematological and cardiological changes including pulmonary hypertension, rarely resulting in potential lethal complications.
We describe five pediatric patients affected by developmental delay or autism, with a restrictive diet, diagnosed with scurvy during the hospitalization: 3 pre-school aged boys presenting with typical clinical presentation, due to severe malnutrition; a 6-year-old girl with refusal to walk and a very high titre of inflammatory markers, without typical signs of scurvy; a 4-year-old boy with severe pulmonary hypertension, rarely related to vitamin C deficiency. In all the cases, a prompt resolution of the symptoms after the administration of vitamin C has been observed, confirming the diagnosis.
At present, scurvy is a more contemporary condition than previously thought. It is fundamental to recognize both typical and atypical manifestations to avoid delay of diagnosis or rarely life-threatening complications.
最近有报道称，小儿坏血病的发病率呈上升趋势，尤其是在患有神经精神疾病且饮食单一的儿童中。肌肉骨骼表现，如跛行和拒绝行走，通常是急诊室就诊的主要原因。如今，已证实出现了新的表现形式，如血液学和心脏学变化，包括肺动脉高压，很少会导致潜在的致命并发症。
我们描述了五名患有发育迟缓或自闭症且饮食受限的儿科患者，他们在住院期间被诊断为坏血病：3名学龄前男孩因严重营养不良出现典型临床表现；一名6岁女孩拒绝行走且炎症标志物水平极高，但无典型坏血病体征；一名4岁男孩患有严重肺动脉高压，很少与维生素C缺乏有关。在所有病例中，给予维生素C后症状迅速缓解，从而确诊。
目前，坏血病比以前认为的更为常见。认识典型和非典型表现对于避免诊断延误或罕见的危及生命的并发症至关重要。
