Vitamin C shortage leads to rare Haifa scurvy diagnosis

Rambam pediatrician diagnoses 18th-century "seafarers’ disease" of scurvy in autistic child who refuses to eat fresh produce.

By JUDY SIEGEL-ITZKOVICH
Hospital bed (photo credit: Wikicommons)
Hospital bed
(photo credit: Wikicommons)
A young boy has been diagnosed at Haifa’s Rambam Medical Center with scurvy, the seafarers’ disease common in the 18th century. The boy, who also suffers from autism, agreed to eat only chicken schnitzel and tahini and refused to consume fruits or vegetables, thus causing the severe shortage of vitamin C.
It took some time for doctors to diagnose the potentially fatal disease, as it is a forgotten disorder and very rare. Prof. Riva Brik, head of the pediatrics department, said the parents brought in the autistic child, who is wheelchair bound, suffering from pain in his bones and difficulty walking. Brick, who is a pediatric rheumatologist, gave him anti-inflammatory drugs and found nothing out of ordinary from skeletal x-rays, an MRI scan and blood tests. The child was released, but was brought back a few days later with his parents saying his pain continued.
When the doctor saw he had periodontitis and bleeding from his gums, she thought of scurvy. Brik said that autistic children often refuse to eat certain foods. In this case, the lack of vitamin C caused the symptoms.
Scurvy may also result when children have allergies to foods containing vitamin C.
At the end of the 1700s, sailors realized that their health problems were being caused by a lack of fruits and vegetables and took care to add them to their voyage. In the 1930s, Vitamin C was identified as the substance that, when missing from the diet, caused health problems associated with scurvy.
“I have been a doctor and then director of pediatrics here for 30 years, but I don’t remember such a case of a child with food obsessions that prevented him from getting vitamin C,” she said. “Today, many processed foods – even cornflakes – have added vitamins including C. But of course, I recommend getting it naturally from fresh vegetables and fruits.”