Arthritis and gum bleeding in two children
Article first published online: 13 MAR 2009
© 2009 The Authors. Journal compilation © 2009 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 45, Issue 3, pages 158–160, March 2009
How to Cite
Vitale, A., Torre, F. L., Martini, G., Calcagno, G., Fede, C., Conti, G., Chimenz, R. and Zulian, F. (2009), Arthritis and gum bleeding in two children. Journal of Paediatrics and Child Health, 45: 158–160. doi: 10.1111/j.1440-1754.2009.01466.x
- Issue published online: 13 MAR 2009
- Article first published online: 13 MAR 2009
- Accepted for publication 22 July 2008.
- differential diagnosis;
- gum bleeding;
- juvenile arthritis;
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.