Scurvy: Just Think about It

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  • Scurvy: Just Think about ItFigure 2. Bilateral knee radiograph showing marked rightknee swelling.An 11-year-old boywith epileptic encephalopathy due tocongenital cytomegalovirus infection presented to ourhospital with a 6-month history of hemorrhagic gingi-

    vitis (Figure 1) associated with marked anemia, relevant rightgonalgia with antalgic flexion, and diffused skin coarseness.

    Bilateral knee radiograph showed marked right kneeswelling (Figure 2); knee echography suggestedsupracondyloid, subperiosteal femoral hematoma, withoutsigns of articular effusion.

    We found profound ascorbic acid (vitamin C) deficiency(

  • Vol. 163, No. 6 December 2013these patients. Because laboratory diagnosis is easy, therapy isreadily available, and response to treatment is rapidall youhave to do is think about it. n

    We thank Lauren Ryan, MD (University of Alberta), for her assistancein editing the English of the final manuscript.Enrico Valerio, MDAlessandra Meneghel, MDSusanna Masiero, MDTiziana Zangardi, MDStefania Zanconato, MDDepartment of Woman and Child HealthMedical SchoolUniversity of PaduaPadova, ItalyReferences

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    Scurvy: Just Think about ItReferences