Abstract
We report the case of a 14-year-old boy with a completely normal medical and social background (good student and handball practice). A dentist monthly followed this patient for an orthodontic treatment. Facing with symptoms associating purpura, pancytopenia, and limbs pain, the first diagnosis that came to mind to emergency pediatricians was acute leukemia and the patient was addressed to a hematology department. However, additional psychiatry investigations revealed an avoiding restrictive food intake disorder (ARFID) associated with serious vitamin deficiencies (Vitamins B9 and D) and responsible for scurvy, mimicking acute leukemia onset. Strikingly, this young patient has been undergoing a close medical follow-up since infancy because of a selective diet. Since growth, education, and development were normal, the risk of pursuing this unbalanced diet has been neglected and this child was admitted at diagnosis in a life-threatening condition.
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References
Padayatty SJ, Levine M. New insights into the physiology and pharmacology of vitamin C. CMAJ. 2001;164:353–5.
Ceglie G, Macchiarulo G, Marchili MR, Marchesi A, Rotondi Aufiero L, Di Camillo C, et al. Scurvy: still a threat in the well-fed first world? Arch Dis Child. 2018;104:381–3. https://doi.org/10.1136/archdischild-2018-315496.
Agarwal A, Shaharyar A, Kumar A, Bath MS, Mishra M. Scurvy in pediatric age group—a disease often forgotten? J Clin Orthop Trauma. 2015;6:101–07. https://doi.org/10.1016/j.jcot.2014.12.003.
Fisberg M, Brambilla A, Pizza C, Lachina L, Resti M, Trapani S. Pediatric scurvy: when contemporary eating habits bring back the past. Front Pediatr. 2018;6:126. https://doi.org/10.3389/fped.2018.00126.
Valentini D, Barbuti D, Grandin A, De Horatio LT, Villani A. A good growth in a child with scurvy. BMJ Case Rep. 2011. pii: bcr1020103383. https://doi.org/10.1136/bcr.10.2010.3383.
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Benezech, S., Hartmann, C., Morfin, D. et al. Is it leukemia, doctor? No, it’s scurvy induced by an ARFID!. Eur J Clin Nutr 74, 1247–1249 (2020). https://doi.org/10.1038/s41430-020-0640-5
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DOI: https://doi.org/10.1038/s41430-020-0640-5
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