Evidence map›Paper›PMID 38760753›Full record

ArticlePediatric rheumatology online journal2024

Scurvy masquerading as IgA vasculitis.

Hanna L Kassa, S Singh, M Douglas-Jones, Gill Schermbrucker, J De Lange, Frank Phoya, Claire Butters, Carol Hlela, Ashton Coetzee, Ebrahim Banderker and 1 more

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric rheumatology online journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Hanna L KassaDepartment of Pediatric Rheumatology, Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa. Hanna.lishan@aau.edu.et.ORCID http://orcid.org/0000-0002-4668-2575
S SinghNational Health Laboratory Service, Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa.
M Douglas-JonesDepartment of Maxillofacial and Oral Surgery, Groote Schuur and Red Cross Children's Hospital, University of the Western Cape, Cape Town, South Africa.
Gill SchermbruckerVictoria Hospital, Wynberg, Cape Town, South Africa.
J De LangeDepartment of Maxillofacial and Oral Surgery, Groote Schuur and Red Cross Children's Hospital, University of the Western Cape, Cape Town, South Africa.
Frank PhoyaRed Cross Children's Hospital, University of Cape Town, Cape Town, South Africa.
Claire ButtersRed Cross Children's Hospital, University of Cape Town, Cape Town, South Africa.
Carol HlelaRed Cross Children's Hospital, University of Cape Town, Cape Town, South Africa.
Ashton CoetzeeDepartment of Paediatric Nephrology, Red Cross Childrens Hospital, University of Cape Town, Cape Town, South Africa.
Ebrahim BanderkerRed Cross Children's Hospital, University of Cape Town, Cape Town, South Africa.
Kate WebbRed Cross Children's Hospital, University of Cape Town, Cape Town, South Africa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVitamin C deficiency, or scurvy, is rare but poses risks for children with poor diets, limited resources, or malabsorption issues. It may also be common in children with restrictive or selective dietary habits in children with global developmental delay, autism spectrum disorder, and physical disabilities. Symptoms include fatigue, irritability, joint and muscle pain, joint swellings, edema, swollen gums, easy bruising, and delayed wound healing. Early recognition and prompt intervention are essential to prevent the progression of symptomatic vitamin C deficiency in children. CASE PRESENTATION: We present a case of a 13-year-old boy with developmental delay secondary to Lennox Gastaut syndrome referred for suspected recurrent, severe, and atypical IgA vasculitis. He presented with irritability, loss of appetite, petechial and ecchymotic lower limb lesions, unilateral gum swelling, severe arthritis, peripheral oedema, severe weight loss, anaemia, and raised inflammatory markers. Multiple investigations were performed before the diagnosis of scurvy was made. A surgical finding of friable gingival tissue with multiple loose teeth, a skin biopsy with follicular hyperkeratosis and extravasated perifollicular red blood cells, and a typical X-ray finding led to the diagnosis of scurvy.

conclusionScurvy should be given careful consideration as a differential diagnosis in patients presenting with musculoskeletal issues, mucocutaneous complaints, and constitutional symptoms such as malaise, asthenia, irritability, and loss of appetite. A focused and detailed dietary history looking for a lack of good sources of vitamin C can be an easy indicator of this differential. Imaging studies revealing the typical features can also help make the diagnosis. Pathology of the skin revealing pathognomonic features can add to the certainty of the diagnosis. In the absence of all else, the rapid response to treatment with an appropriate dose of vitamin C has a diagnostic and therapeutic role.

Indexed as

Ascorbic AcidScurvyAdolescentDiagnosis, DifferentialHumansIgA VasculitisMaleAscorbic AcidHenoch Schonlein PurpuraIgA vasculitisPurpuric-rashScurvySelective-dietVitamin-C

Identifiers

PMID38760753
PMCPMC11102241

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.