SHM Converge Scientific Abstract ePoster Gallery-A Tale of 18th-Century Sailors' Ailment Versus 21st-Century Healthcare Systems

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This case describes a 7-year-old boy with autism, developmental delay, severe dietary restriction, and iron deficiency anemia who presented with decreased oral intake, swollen gums, and refusal to bear weight. After evaluation by multiple specialties, he was diagnosed with scurvy due to an undetectable vitamin C level.<br /><br />His symptoms included red, swollen gums, leg pain, refusal to walk, and poor intake and urine output. Exam showed thin appearance, violaceous edematous gums, low muscle tone, lower-extremity tenderness, and later petechiae. Imaging showed mild growth-line changes, and lab work confirmed vitamin C deficiency.<br /><br />Treatment began with IV vitamin C on day 1, then nasogastric tube feeding on day 3. He improved rapidly, beginning to bear weight by day 5, with petechiae resolving by day 7. A G-tube was placed on day 8, and he was discharged on enteral vitamin C on day 9.<br /><br />The report highlights that while scurvy is rare, the more important issue was the system failures surrounding his care. Over two years, he had seen several hospitals and outpatient specialists, but no one unified the nutritional concerns. A previously discussed G-tube was not followed up with GI, a feeding clinic waitlist lasted 18 months, and he remained hospitalized five extra days after becoming medically stable to expedite long-term nutrition support. These delays show problems in outpatient coordination, specialist access, and care integration that can harm patients with complex needs.

Asset Subtitle

Emily L. Jacobson

Meta Tag

Author List Aditi Hindka, Emily L. Jacobson, Katherine O. Salada

Category Clinical Vignettes

Concept Pediatric Scurvy

Concept Vitamin C Deficiency

Concept Vitamin C Replacement Therapy

Concept Gingivitis

Concept Refusal to Bear Weight

Distinguished Non-Finalist

Presenter Organization University of Michigan

Presenting Author Emily L. Jacobson

Track Pediatric

Keywords

scurvy

vitamin C deficiency

autism

developmental delay

iron deficiency anemia

severe dietary restriction

gingival swelling

refusal to bear weight

pediatric nutrition

care coordination

Pediatric Scurvy

Vitamin C Deficiency

Vitamin C Replacement Therapy

Gingivitis

Refusal to Bear Weight