Scurvy, a condition caused by a deficiency in ascorbic acid, is often considered an outdated, textbook disease, largely forgotten in the 21st century. However, recent reports indicate a rise in cases, particularly among individuals with risk factors for nutritional deficiencies or those with specific dietary habits. These cases are frequently misdiagnosed, leading to a series of unnecessary tests that could be avoided with a thorough assessment of dietary intake. In this report, we present the case of a 10-year-old with autism spectrum disorder (ASD) and a selective eating pattern, who presented with a limping gait, tenderness in the right calf, and significant weight loss. A skin examination revealed multiple perifollicular hemorrhages with corkscrew-shaped hair, as well as localized erythematous and hypertrophic gingiva in all four quadrants. Based on clinical findings, scurvy was suspected, and vitamin C supplementation was initiated both for diagnostic and therapeutic purposes. The diagnosis was confirmed when serum vitamin C levels were found to be critically low (5 µmol/L, normal range: 28-120 µmol/L). The patient's response to vitamin C was impressive, with complete gingival healing and noticeable weight gain within three weeks. Although scurvy is often thought of as an ancient disease, it has seen a resurgence, posing diagnostic challenges due to its diverse clinical manifestations. Early diagnosis, along with appropriate intervention and dietary changes, can lead to an excellent prognosis for individuals with scurvy.
Logonathan et al. (Fri,) studied this question.