Scurvy in a Pediatric Patient with Restrictive Eating for Dietary Management - Case Study

Sri vamsi krishna ¹, Nabeel Nazeer ¹, Bharath A S ¹, Magesh C ^1*

This case determined the importance of addressing restrictive eating patterns and dietary limitations in children, particularly those with special needs, to prevent vitamin C deficiency and support overall health.

Abstract

Background: Recent literature highlights that children with special needs, such as those with autism spectrum disorders (ASD) or intellectual disabilities, are disproportionately affected by vitamin deficiencies due to selective eating behaviors. This case report presents a six-year-old boy with vitamin C deficiency and explores the broader implications for dietary management in children with restrictive eating patterns. Methods: The patient, a typically developing six-year-old boy, initially presented with a recurrent rash sensitive to sunlight. He was diagnosed with ichthyosis vulgaris and later referred for decreased appetite. Three weeks later, he presented with bilateral lower extremity pain and was diagnosed with tenosynovitis. Further evaluation revealed severe vitamin C deficiency, with a serum vitamin C level of <6 µmol/L. The patient was admitted to an intensive day treatment feeding program where a comprehensive feeding assessment identified lifelong selective eating patterns. The intervention involved gradual exposure to new foods, and follow-up assessments were conducted over eight months. Results: Following the intensive feeding treatment, the child successfully learned to eat 29 new foods from various food groups. One year after treatment, his body mass index (BMI) increased from the 1st percentile to the 85th percentile, reflecting significant improvements in both growth and nutritional status. The child continued to be monitored by a feeding therapist, who helped sustain the progress and ensure dietary diversity. Conclusion: This case underscores the critical role of addressing underlying dietary issues in children with vitamin deficiencies. While vitamin C supplementation effectively resolves the deficiency, it does not address the root cause of selective eating patterns. Children with special needs are at higher risk for nutritional deficiencies due to restrictive eating habits, necessitating early intervention and specialized dietary management.

Keywords: Vitamin C, Scurvy, Dietary Deficiencies, Autism Spectrum Disorder, Feeding Interventions

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