SHM Converge Scientific Abstract ePoster Gallery-From Head to Toe: The Multi-Systems Presentation of Scurvy in a 4 Year Old

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This case highlights the multisystem presentation of scurvy in a 4-year-old child with developmental delay and a severely restricted diet of yogurt, homemade flat bread, raisins, and water. The patient initially presented with a 5% weight loss over two months and a left femoral metaphyseal fracture, followed by refusal to bear weight, severe leg pain, progressive irritability, and further weight loss.<br /><br />Physical examination showed a thin, malnourished child with diffuse papular rash on the forearms, dental decay with gingival bleeding, marked pain with passive limb movement, and refusal to walk. Laboratory findings revealed microcytic anemia, low iron and transferrin saturation, mild hypoalbuminemia, and hematuria. Inflammatory markers and other nutritional labs were largely unremarkable. A vitamin C level later returned undetectable.<br /><br />Because of the combination of mucosal bleeding, limb pain, rash, irritability, and nutritional risk factors, oral vitamin C was started before the level resulted. The patient was diagnosed with scurvy and malnutrition. With vitamin C replacement and enteral feeding, he gained weight, improved clinically, and was discharged.<br /><br />The key teaching point is that scurvy remains a clinical diagnosis and should be considered in children with restricted diets and compatible symptoms. Serum vitamin C may help confirm the diagnosis, but normal levels do not exclude it. Early recognition and prompt vitamin C treatment are low-risk interventions that can rapidly improve symptoms and prevent severe complications or death.

Asset Subtitle

Grace Buckley

Meta Tag

Author List Claudia Heritage, Grace Buckley, Hannah Miller, Wael N. Sayej

Category Clinical Vignettes

Concept Vitamin C Deficiency

Concept Restrictive Diet

Concept Malnutrition

Concept Vitamin C Replacement Therapy

Concept Musculoskeletal Manifestation

Distinguished Non-Finalist

Presenter Organization UMass Chan Baystate

Presenting Author Grace Buckley

Track Pediatric

Keywords

scurvy

vitamin C deficiency

pediatric malnutrition

restricted diet

developmental delay

gingival bleeding

limb pain

fracture

microcytic anemia

oral vitamin C

Vitamin C Deficiency

Restrictive Diet

Malnutrition

Vitamin C Replacement Therapy

Musculoskeletal Manifestation