Angiogenesis, Inflammation & Therapeutics | Online ISSN  2207-872X
CASE STUDY   (Open Access)

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*

+ Author Affiliations

Journal of Angiotherapy 5(2) 1-5 https://doi.org/10.25163/angiotherapy.52621552919191221

Submitted: 29 December 2021  Revised: 08 December 2021  Published: 19 December 2021 

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

References

Ali, S. R., Hamilton, R., Callaghan, M., Brown, A., & Gibson, L. (2014). G429 (P) A 13-year-old with fussy-eating induced blindness. Archives of Disease in Childhood, 99, A179-A180. https://doi.org/10.1136/archdischild-2014-306237.411

Baird, J. S., & Ravindranath, T. M. (2015). Vitamin B deficiencies in a critically ill autistic child with a restricted diet. Nutrition in Clinical Practice, 30(1), 100-103. https://doi.org/10.1177/0884533614541483

Golriz, F., Donnelly, L. F., Devaraj, S., & Krishnamurthy, R. (2017). Modern American scurvy—Experience with vitamin C deficiency at a large children's hospital. Pediatric Radiology, 47(2), 214-220. https://doi.org/10.1007/s00247-016-3726-4

Harknett, K. M., Hussain, S. K., Rogers, M. K., & Patel, N. C. (2014). Scurvy mimicking osteomyelitis: Case report and review of the literature. Clinical Pediatrics, 53(10), 995-999. https://doi.org/10.1177/0009922813506609

Kapadia, M., Beck, M., Comito, M., & Dandekar, S. (2016). Malignancy vs. scurvy: Similar manifestations, different pathophysiology—Case series. Pediatric Blood & Cancer, 63, S86.

Keown, K., Bothwell, J., & Jain, S. (2013). Nutritional implications of selective eating in a child with autism spectrum disorder. BMJ Case Reports, 14, 123-129.

O'Hara, C. (2015). Scurvy related to the use of a homemade tube feeding formula. Infant, Child, & Adolescent Nutrition, 7, 381-384. https://doi.org/10.1177/1941406415616373

Paul, C., Williams, K. E., Riegel, K., & Gibbons, B. (2007). Combining repeated taste exposure and escape prevention: An intervention for the treatment of extreme food selectivity. Appetite, 49(3), 708-711. https://doi.org/10.1016/j.appet.2007.07.012

Solanki, M., Baweja, D. K., Patil, S. S., & Shivaprakash, P. K. (2011). Ascorbic acid deficiency: A case report. Journal of Dentistry for Children, 78(2), 115-119.

Williams, K. E., Hendy, H. M., Field, D. G., Belousov, Y., Riegel, K., & Harclerode, W. (2015). Implications of avoidant/restrictive food intake disorder (ARFID) on children with feeding problems. Child Health Care, 44(4), 307-321. https://doi.org/10.1080/02739615.2014.921789

Willmott, N. S., & Bryan, R. A. E. (2008). Scurvy in a child with epilepsy on a ketogenic diet with oral complications. European Archives of Paediatric Dentistry, 9(3), 148-152. https://doi.org/10.1007/BF03262627

PDF
Full Text
Export Citation

View Dimensions


View Plumx



View Altmetric



5
Save
0
Citation
601
View
0
Share