Oral Manifestations in Scurvy Pediatric Patients: A Systematic Review and a Case Report

Abstract

Scurvy is generated by lack of vitamin C; although it is considered a rare and past disease, scurvy continues to be detected in children with neurodevelopmental disorders and with selective diet habits. Identifying scurvy can be demanding due to the perceived rarity of the condition, and it can become a tricky diagnostic question given to the variety of nonspecific symptoms, including gingival manifestations. This study aims to identify most common clinical features in order to provide a complete picture of the signs and symptoms, and to offer clinicians the diagnostic tools for identifying patients suffering from scurvy. We present a case report of a child affected by scurvy; it has also been performed as a systematic review about scurvy in pediatric population. A search yielded 107 relevant studies since 1990. Most of the identified cases have shown oral, musculoskeletal and cutaneous manifestation that improved within a few days of starting vitamin C therapy. Identifying scurvy’s characteristic clinical features allows a timely diagnosis, thus avoiding invasive investigations. Pediatric dentists should possess adequate knowledge and experience to identify the main characteristics of scurvy. This can help facilitate a prompt diagnosis in order to provide timely intervention to the patient that is relatively ease and safe.

Scurvy mimic acute Leukemia in a female child and review of literature

“…These include hematological illnesses, severe food allergies, neurological disorders such autism, anorexia, cerebral palsy, and developmental delay, as well as other dietary restriction factors like fructose intolerance. 3,5 An unusual aspect of the present case was the absence of any potential risk factors, which demonstrates that scurvy may still be occasionally encountered in the pediatric population, even in individuals with no predisposing disorders, living in families without unusual eating habits. Also, this case was having a feature of scurvy even with no risk factor and associated with leukemia.…”

“…10 Scurvy may have features of pseudo-paralysis, simulating osteomyelitis or tumor as differential diagnosis. 5 Scurvy is a diagnosis that could be missed easily. It is rare cause of bone and joint symptoms, and this rarity of occurrence as compared to other nutritional deficiencies frequently leads to delayed recognition of this disorder (11) .…”

“…Furthermost of characteristic disorders of vitamin C deficiency can overlie with rheumatological, infectious or hematological malignancy diseases, viewing a broad variety of musculoskeletal and mucocutaneous manifestations, consequently mimicking other pediatric conditions (5) . The early signs include nonspecific features include irritability, loss of appetite, low grade fever, and later, petechiae, ecchymoses, hyperkeratosis, and corkscrew hairs.…”

Scurvy presenting primarily as gingival manifestation in a young child: a diagnostic dilemma

“…In a more recent systematic review of literature by Gicchino et al showed that 51% of patients presenting with scurvy were affected by neurodevelopmental disorders and 83% of these patients, presented with oral manifestations. The most common oral manifestation cited in their review were gingival bleeding, swelling and hypertrophy 15…”

The Impact of Vitamin Deficiencies on Oral Manifestations in Children

“…Scurvy, the disease caused by vitamin C deficiency, though often considered a historical condition, persists today, especially among children with neurodevelopmental issues or selective diets. The diagnosis of scurvy can be challenging due to its rarity and the diversity of its nonspecific symptoms, which include gingival changes [112]. Vitamin C is also crucial for immune function, with a noted increase in infection susceptibility in deficient individuals; it is even considered for adjunctive sepsis therapy [113].…”