ascorbic-acid and Cerebral-Palsy

Topics: Ascorbic Acid; Cerebral Palsy; Child; Child Nutrition Disorders; Disabled Children; Enteral Nutrition; Female; Food, Formulated; Humans; Male; Nutrition Therapy; Rett Syndrome; Scurvy; Treatment Outcome; Vitamins

We report three cases of scurvy, with differing musculoskeletal presentations, from a tertiary teaching hospital in Sydney, Australia. Case 1 was a man with cerebral palsy who presented with knee swelling following a minor injury. In Case 2, a patient with thalassaemia major presented with purpuric rash, difficulty walking and distal thigh swelling and ecchymosis. Case 3 was a man with Down's syndrome who presented with acute ankle arthritis. Scurvy in Cases 1 and 3 were related to abnormal dietary preferences, whereas in Case 2, scurvy was thought to be related to thalassaemia. All three cases responded rapidly to vitamin C replacement. The subjects did not appear malnourished as they had adequate carbohydrate and protein intake.

Topics: Adult; Ascorbic Acid; Ascorbic Acid Deficiency; beta-Thalassemia; Cerebral Palsy; Down Syndrome; Feeding Behavior; Hospitals, Teaching; Humans; Male; Scurvy; Treatment Outcome

An 8-year-old child with cerebral palsy came with progressive purpuric rash affecting the trunk and legs. He had tenderness on palpation of his extremities. Physical examination revealed a moderately pale and cachectic boy. There was bleeding per swollen gums and petichiae on the hard palate. Generalized multiple discrete palpable petichiae spots at hair follicles along the whole body, more on both legs, were observed. He also had tenderness on palpation of his extremities. His hemoglobin was 6.6 g/dl. Platelet count and coagulogram were normal. Roentgenographic findings showed generalized osteoporosis, metaphyseal white line of distal femur, proximal tibia. proximal fibula, distal radius, and distal ulna with submetaphyseal lucency bilaterally. Skin biopsy showed dilated hair follicles, filled with keratinous material and a small corkscrew hair. A diagnosis of scurvy was made; and vitamin C at a dosage of 300 mg per day was given. His swollen gums, bleeding per gums and muscle tenderness improved within 2 days. Perifollicular hemorrhage, follicular hyperkeratosis, and anemia improved in 2 and 3 weeks respectively.

Topics: Ascorbic Acid; Cerebral Palsy; Child; Humans; Iron Compounds; Male; Prognosis; Scurvy; Severity of Illness Index; Thailand; Treatment Outcome

Topics: Ascorbic Acid; Cerebral Palsy; Child; Disabled Children; Folic Acid; Gingivitis; Humans; Infant; Intellectual Disability; Vitamin A; Vitamin B Complex; Vitamin K; Vitamins