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Arthritis and gum bleeding in two children
Author(s) -
Vitale Agata,
Torre Francesco La,
Martini Giorgia,
Calcagno Giuseppina,
Fede Carmelo,
Conti Giovanni,
Chimenz Roberto,
Zulian Francesco
Publication year - 2009
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/j.1440-1754.2009.01466.x
Subject(s) - medicine , ecchymosis , hemarthrosis , pediatrics , presentation (obstetrics) , arthritis , purpura (gastropod) , surgery , dermatology , ecology , biology
In developed countries, scurvey is quite rare and can be seen in children with severely restricted diets, related to psychiatric or developmental problems. Clinical presentation can include arthralgias/arthritis, myalgias, hemarthrosis, purpura and ecchymosis. We report two cases of nutritional vitamin C deficiency, who have been misdiagnosed as having rheumatologic diseases, and promptly resolved with vitamin C treatment. Both patents did not have the classic radiological features described in scurvey, such as the Wimberger ring or the white lines of Frankel. Magnetic resonance imaging clearly showed areas of hemorrhage at bony and subperiasteal level. This imaging procedure, therefore, should be recommended especially in the doubtful cases. The two patients described herein should alert pediatricians to consider scurvey although rare, as a potential source of “rheumatological” manifestations in children, especially in the industrialized courtries where in appropriate vitamin intake is often underestimated.