Identification and management of Psedoparalysis from scurvy: two cases report at Mahasarakham Hospital

Abstract

Scurvy (vitamin C deficiency) is a rare disease in children. It is potentially fatal but easily curable. Symptoms are bleeding per gum, ecchymosis, swelling gum, fever, bone pain and inability to walk. The diagnosis of scurvy is made on clinical grounds and radiographic evaluated of long bones.

Two cases boy presented with leg pain, mild swelling around knee joint and inability to walk for 2-4 weeks. Basic blood workup was shown anemia. Radiological findings was shown diffuse osteopenia at metaphysis, dens metaphyseal band, lucent metaphyseal band of bilateral femur and left distal femoral metaphyseal spur, compatible with scurvy. vitamin C replacement were given both cases.  Few months after treatment pain and swelling substantially reduced and the child became able to walk. Repeat radiographic showned improvement.

Conclusion although scurvy is rare in the modern era, inappropriate dietary intake can lead to skeletal abnormalities which may be confused with rickets, infection or inflammation conditions. A high index of suspicion is thus required for prompt diagnosis of scurvy in patients with bone and joint symptoms.

Key words : scurvy, vitamin C deficiency