Scurvy and vitamin C deficiency in an Australian tertiary children's hospital.

Autor: van Heerden C; Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.; Murdoch Children's Research Institute, Melbourne, Victoria, Australia., Cheng DR; Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.; Murdoch Children's Research Institute, Melbourne, Victoria, Australia.; Centre for Health Analytics, Melbourne, Victoria, Australia., McNab S; Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.; Murdoch Children's Research Institute, Melbourne, Victoria, Australia., Burgess R; Murdoch Children's Research Institute, Melbourne, Victoria, Australia., Russell A; The University of Melbourne, Melbourne, Victoria, Australia., Wang Y; The University of Melbourne, Melbourne, Victoria, Australia., Bleathman F; Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia., Maharaj I; Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia., Zhang J; The University of Melbourne, Melbourne, Victoria, Australia., Easterbrook M; The University of Melbourne, Melbourne, Victoria, Australia., Papadopulos M; The University of Melbourne, Melbourne, Victoria, Australia., Ibrahim LF; Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.; Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Jazyk: angličtina
Zdroj: Journal of paediatrics and child health [J Paediatr Child Health] 2024 Sep; Vol. 60 (9), pp. 409-414. Date of Electronic Publication: 2024 Jun 21.
DOI: 10.1111/jpc.16594
Abstrakt: Aim: We aimed to investigate the frequency of vitamin C deficiency scurvy in the Australian paediatric context, describe cohorts at risk, and identify factors associated with development of symptoms in children with vitamin C deficiency. We also aimed to propose a management guideline for children with features of scurvy.
Method: A retrospective study was done at a tertiary paediatric hospital in Australia over a three-year period, from August 2019 to July 2022. Children from birth to 18 years old, whose vitamin C levels were low (<23 μmol/L), were included. Data extracted from hospital medical records included demographics, weight, co-morbidities, eating disorder diagnoses, clinical features, investigations and treatment. Descriptive statistics and risk statistics were performed.
Results: In a cohort of 887 patients who had their vitamin C levels checked, we identified 272 (31%) who had a vitamin C level <23 μmol/L. Of these, 13 (5%) were symptomatic of vitamin C deficiency and 19 (7%) may have been symptomatic. In patients with vitamin C deficiency, 248 (91%) had comorbidities, neurodevelopmental disorders being most common, and 176 (65%) had restricted eating. When the asymptomatic and symptomatic groups were compared, in the symptomatic group, there was a significantly lower vitamin C level and disordered eating related to autism spectrum disorders was more common.
Conclusion: In order to avoid delayed diagnoses and unnecessary investigations, clinicians should be familiar with symptoms of scurvy and perform a dietary assessment, vitamin C assay, and commence empiric vitamin C supplementation where appropriate.
(© 2024 The Author(s). Journal of Paediatrics and Child Health published by John Wiley & Sons Australia, Ltd on behalf of Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)
Databáze: MEDLINE