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Scurvy as an Alarm Bell of Autistic Spectrum Disorder in the First World: A Case Report of a 3-Year-Old Girl

Challenging differential diagnosis, Unusual setting of medical care, Patient complains / malpractice, Rare disease

Maria Liuzzo Scorpo, Giovanni Corsello, Maria Cristina Maggio

Italy Department PROMISE “G. D’Alessandro”, University of Palermo, Palermo, Italy

Am J Case Rep 2021; 22:e930583

DOI: 10.12659/AJCR.930583

Available online: 2021-06-22

Published: 2021-08-02


#930583

BACKGROUND: Scurvy secondary to deficiency of vitamin C is a rare condition in children. The polymorphism of clinical signs and symptoms makes scurvy diagnosis a challenge for the pediatrician.
CASE REPORT: A 3-year-old girl came to our observation because she refused to walk and to stand, she showed petechiae, follicular hyperkeratosis on the limbs, and bleeding gums. After a physical exam, laboratory tests, and X-ray examinations, we suspected scurvy disease and started treatment with vitamin C. During the hospitalization, some relationship difficulties of the little girl emerged such as absence of eye contact, smiling and laughter without reason, solitary play activities, poor interaction with strangers, non-communicative language, and gestural stereotypes. Therefore, we suspected an autism spectrum disorder, which is often associated with vitamins intake deficiency secondary to food selectivity. After the administration of vitamins, there was a clinical improvement. Due to the suspicion of autism spectrum disorder, the neuropsychiatric team started neuro-psychomotor and speech therapy.
CONCLUSIONS: This case shows that although the incidence of scurvy has been greatly reduced in Western Europe, this pathology can still manifest itself, especially in vulnerable children, and its prompt diagnosis and therapy are important considering the excellent response to treatment.

Keywords: Ascorbic Acid Deficiency, Autistic Disorder, Scurvy



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