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Vitamin C deficiency mimicking inflammatory bone disease of the hand. | LitMetric

Vitamin C deficiency mimicking inflammatory bone disease of the hand.

Pediatr Rheumatol Online J

Division of Rheumatology, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.

Published: June 2020

AI Article Synopsis

Article Abstract

Background: Severe vitamin C deficiency, or scurvy, encompasses a syndrome of multisystem abnormalities due to defective collagen synthesis and antioxidative functions. Among the more common presentations is a combination of oral or subcutaneous hemorrhage with lower extremity pain, the latter often exhibiting inflammatory bone changes on magnetic resonance imaging (MRI).

Case Presentation: A 12-year-old male with anorexia nervosa presented with asymmetric painful swelling of multiple fingers of both hands. Imaging demonstrated soft tissue and bone marrow edema of several phalanges, without arthritis, concerning for an inflammatory process. Extensive imaging and laboratory evaluations were largely unrevealing, with the exception of a severely low vitamin C level and a moderately low vitamin D level. A diagnosis of scurvy was made and supplementation was initiated. Within 3 weeks of treatment, serum levels of both vitamins normalized and the digital abnormalities resolved on physical exam.

Conclusions: This represents the first description of scurvy manifesting with bone and soft tissue changes limited to the hands. There must be a high index of suspicion for scurvy in children with restricted dietary intake or malabsorption who have bone pain, irrespective of location of the lesions.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285567PMC
http://dx.doi.org/10.1186/s12969-020-00439-4DOI Listing

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