By Drs. David Niesel and Norbert Herzog
Parents worry if their children are getting a good diet that will allow them to grow up healthy and strong. It came as somewhat of a shock when parents of a toddler in Spain were told their child was suffering from scurvy, a lack of vitamin C. After all, wasn't scurvy what plagued sailors of old? It could not be the case in modern Spain.
The pregnancy was uneventful and his birth weight was a respectable 6.8 pounds. He received the recommended vaccinations and for the first two and a half months of life was fed a cow's milk based formula in lieu of human breast milk. He developed a rash and his diet was changed to an almond based formula. Beginning at about six months the mother tried to introduce pureed fruits and vegetables but they were refused. From two and a half to 11 months, the toddler only ate a mixture of almond milk and other grains with some added probiotics. At seven months, he could sit with support, but one month later he was less stable sitting. Though he continued to grow longer, his weight gain plateaued and declined by 11 months. He appeared fairly healthy but irritable and could not support his legs on a solid surface and cried when his legs were moved passively.
Leg X-rays showed signs of bone density loss, called osteopenia, thinning of bone and other features linked with changes associated with scurvy as well as a fracture of his right leg. He also had numerous abnormalities in his blood work including extraordinary low levels of vitamins C and D. These results, along with his nutritional history, pointed to a diagnosis of infantile scurvy.
Scurvy is caused by a lack of vitamin C in the diet and results in defects in the protein, collagen, which is found in bones, muscles, skin and tendons, which provides structural support and strength. Vitamin C is also required for the growth and maintenance of bones. Scurvy leads to general weakness, anemia, gum disease and hemorrhages in the skin. Humans cannot make vitamin C, therefore it must be acquired in the diet from fruits, vegetables or vitamin supplements. Bone growth is particularly rapid during the first two years of life, then continues in spurts until the late teens or early twenties. The fact that this child was not receiving sufficient amounts of vitamin C and D meant that his bones could not form properly and became thin and brittle. An analysis of the toddler's diet revealed that his diet was also low in calcium, iron and zinc. Plant based infant formulas have become increasingly popular in developed countries in recent years. The toddler was placed on vitamin C replacement therapy with 300mg/day. In the next three months his condition rapidly improved with less leg pain and fewer radiological findings in his bones. The vitamin C levels returned to normal and he started to walk, much to his parent's relief. This could have been avoided by breast feeding which carries with it many other benefits.
Medical Discovery News is hosted by professors Norbert Herzog at Quinnipiac University, and David Niesel of the University of Texas Medical Branch. Learn more at www.medicaldiscoverynews.com.