Aumento de la frecuencia de escorbuto en niños con selectividad alimentaria: serie de casos / Increase in the frequency of scurvy in children with food selectivity: A case series

El escorbuto es una enfermedad producida por déficit de vitamina C. Aunque es poco frecuente, en los últimos años observamos un incremento de casos en niños con trastornos de la conducta alimentaria. Sus manifestaciones son variadas, ya que esta vitamina actúa como cofactor en numerosos procesos, como la síntesis de colágeno. Las manifestaciones cutáneas características son las petequias, equimosis e hiperqueratosis. El compromiso mucoso se manifiesta como gingivitis con hipertrofia, hemorragias y pérdida de piezas dentarias. El diagnóstico es clínico y puede confirmarse mediante la determinación de la vitamina C plasmática. El objetivo de este trabajo es describir una cohorte de pacientes diagnosticados en los últimos años, manifestaciones clínicas y hallazgos en relación con su conducta alimentaria y trastornos del neurodesarrollo.

Scurvy is a disease caused by vitamin C deficiency. Although rare, in recent years, the number of scurvy cases in children with eating disorders has increased. Its manifestations are varied because vitamin C is a cofactor in numerous processes, such as collagen synthesis. The typical skin manifestations include petechiae, bruising, and hyperkeratosis. Mucosal involvement manifests as gingivitis with hypertrophy, bleeding, and loss of teeth. The diagnosis is based on clinical findings and may be confirmed by measuring plasma vitamin C levels. The objective of this study was to describe a cohort of patients diagnosed with scurvy in recent years, its clinical manifestations, and findings in relation to their eating behavior and neurodevelopmental disorders.

Scurvy in a patient with AIDS: case report / Escorbuto em paciente com AIDS: relato de caso

We report the case of a 35-year-old homeless alcoholic and illicit drug user, with AIDS, who was admitted to the emergency unit complaining of asthenia and a weight loss of 30kg over the preceding three months. Clinical and laboratory data confirmed a diagnosis of marasmus, bacterial pneumonia, chorioretinitis caused by Toxoplasma gondii and oral Candida infection. The patient also presented loss of tongue papillae, gingival hypertrophy, perifollicular hyperkeratosis and hemorrhage, coiled, corkscrew-like hair, anemia, hypoalbuminemia, increased C-reactive protein levels and low serum vitamin C levels. The patient developed severe gastric hemorrhage, with hemodynamic instability and terminal disseminated intravascular coagulopathy.

Relatamos o caso de um paciente alcoólatra e usuário de drogas ilícitas com 35 anos de idade, morador de rua com AIDS, admitido na Unidade de Emergência referindo astenia e perda ponderal de trinta quilos nos últimos três meses. Dados clínicos e laboratoriais confirmaram o diagnóstico de marasmo, pneumonia, corioretinite por Toxoplasma gondii e candidíase oral. Apresentava ainda: língua despapilada com hipertrofia gengival, hiperqueratose e hemorragia folicular associada a pêlos tipo saca-rolhas, anemia, hipoalbuminemia, aumento dos níveis de proteína C reativa com baixos níveis séricos de vitamina C. O paciente desenvolveu hemorragia gástrica grave, com instabilidade hemodinâmica e coagulação intravascular disseminada terminal.

Complex regional pain syndrome type 1 and scurvy.

A 5 year old female developed features of complex regional pain syndrome (CRPS) i.e excessive pain to touch, decreased sweating and edema of left ankle 2 years after fracture of left tibia. Gum bleeding, petechiae and pseudoparalysis and suggestive radiograph characterized scurvy. Hyperesthesia improved and child walked with support following administration of vitamin C.

Scurvy: presenting as musculoskeletal pain

The incidence of scurvy in the paediatric population is very low. This report describes a case of scurvy in toddler girl who was admitted with severe pain in legs and difficulty in walking along with bleeding from gums. After extensive investigation, she was found to have vitamin C deficiency resulting from restrictive eating pattern. There was significant improvement in presenting symptoms and general health after introduction of vitamin C and fresh fruits and vegetables to her diet. Nutrition-based diseases can still occur in any socioeconomic setting. Nutritional screening remains an important part in every child's general health care

MR Imaging in a Child with Scurvy: a Case Report

Scurvy is very rare disease in industrialized societies. Nevertheless, it still exists in higher risk groups including economically disadvantaged populations with poor nutrition, such as the elderly and chronic alcoholics. The incidence of scurvy in the pediatric population is very low. This study reports a case of scurvy in a 5-year-old girl with cerebral palsy and developmental delay based on MRI findings.

Pathoecology and paleodiet in Postclassic: Historic Maya from northern coastal Belize

This paper examines the synergism among diet, disease, and ecology at two related coastal Maya sites in Belize (Marco Gonzalez and San Pedro) for the Postclassic and Historic periods (1350-1650 AD), which immediately follow the Classic period collapse. Stable carbon- and nitrogen-isotope ratios in collagen and stable carbon-isotope ratios in structural carbonate were analysed for bones from 65 humans and a wide variety of faunal species. There are no apparent differences in whole diets or degree of carnivory between individuals with lesions indicative of anemia and those without, but those with lesions appear to have consumed significantly more C4 foods and protein from lower trophic levels. Non-specific infection (periostitis) and vitamin C deficiency (scurvy) are also present in high frequencies and appear to co-occur with lesions indicative of anemia, particularly in childhood. Individuals with scurvy also appear to have consumed significantly more C4 foods than normal individuals. Spondyloarthropathy is common in adults. These findings are discussed in light of: (1) the debate on how anemia versus scurvy are manifest and diagnosed, (2) Spanish ethnohistoric descriptions of the poor state of Maya health at the time of contact, and (3) the Osteological Paradox. We suggest that although this coastal environment exacerbated morbidity because of possible parasitic infection, the inhabitants were probably able to survive physiological stresses better than either their inland contemporaries or their modern counterparts.

Scurvy in infantile tremor syndrome.

Infantile Tremor Syndrome is a distinct clinical entity most commonly seen in Indian Subcontinent. Syndrome consists of tremors, mental and developmental retardation, abnormal skin pigmentation and anemia in children between 6 months to 2 years. The etiology is still elusive. Amongst various theories, nutritional theory is the most accepted. So far there are no cases reported of vitamin C deficiency in ITS. In this article, three cases of ITS associated with vitamin C deficiency are reported.

Scurvy: a case report.

An 8-year-old child with cerebral palsy came with progressive purpuric rash affecting the trunk and legs. He had tenderness on palpation of his extremities. Physical examination revealed a moderately pale and cachectic boy. There was bleeding per swollen gums and petichiae on the hard palate. Generalized multiple discrete palpable petichiae spots at hair follicles along the whole body, more on both legs, were observed. He also had tenderness on palpation of his extremities. His hemoglobin was 6.6 g/dl. Platelet count and coagulogram were normal. Roentgenographic findings showed generalized osteoporosis, metaphyseal white line of distal femur, proximal tibia. proximal fibula, distal radius, and distal ulna with submetaphyseal lucency bilaterally. Skin biopsy showed dilated hair follicles, filled with keratinous material and a small corkscrew hair. A diagnosis of scurvy was made; and vitamin C at a dosage of 300 mg per day was given. His swollen gums, bleeding per gums and muscle tenderness improved within 2 days. Perifollicular hemorrhage, follicular hyperkeratosis, and anemia improved in 2 and 3 weeks respectively.

Escorbuto infantil: presentación de dos casos / Infantile scurvy: a report of 2 cases

Se presentan dos lactantes con diagnóstico clínico radiológico de escorbuto. Se discuten las características epidemiológicas, metabólicas y clínicas de esa entidad así como los aspectos salientes de ambos casos.

Escorbuto: revisión de 20 casos / Scurvy: review of 20 cases

Se analizan 20 casos de escorbuto estudiados en el Hospital de Pediatría del Centro Médico Nacional (CMN), IMSS, durante el periodo de marzo de 1963 e abril de 1984. Se analizan algunos aspectos nutricionales e infecciosos, valorándose diferentes aspectos clínicos, de laboratorio y de gabinete. En este estudio se encontró que el destete precoz, la alimentación individual y defectuosa, la ablactación tardía e inadecuada, así como la infección, son generalmente factores que aparecen antes del cuadro clínico del escorbuto. Debe destacarse que todos los pacientes estaban desnutridos y, en la mayoría, la desnutrición era muy acentuada. Por otra parte, el diagnóstico se estableció en todos los casos con base en el cuadro clínico y en imágenes radiológicas. Otro de los datos que se hizo notorio, fue el del predominio de esta enfermedad en los niños menores de un año de edad. Y en cuanto a los datos clínicos observados con mayor frecuencia, se encontraron los siguientes: rosario costal, dolor y aumento de volumen de extremidades, y sangrado en diferentes lugares del cuerpo. La imagen radiológica apoyó, en todos los casos, el diagnóstico de escorbuto. Finalmente se hacen algunas consideraciones sobre la historia del escorbuto, frecuencia de este mal en la actualidad y se revisa la literatura médica correspondiente