Did not eat fruits and vegetables for years: 9-year-old fell ill with scurvy due to severe vitamin C deficiency
The 9-year-old began to limp and his condition deteriorated until he had to move in a wheelchair. At the hospital, it turned out that he was suffering from scurvy due to a severe vitamin C deficiency. "In cases of severe deficiency and significant delay in diagnosis, bone damage and even tooth loss can occur."
A few weeks ago, the parents of Nadav (pseudonym), a 9.5-year-old diagnosed on the autism spectrum, noticed that their son was limping while playing at a playground. At first, they did not attach any special importance to it. "We thought maybe he fell or made some movement on the scooter and we didn't notice. We expected it to pass on its own," says his father. However, the limp worsened, and within weeks Nadav found it increasingly difficult to walk. At the same time, his parents also noticed bleeding gums.
"At a certain stage, we were really worried. When we had to walk 100 meters from the parking lot to the house, it was hard for him, and I would carry him on my back." Nadav underwent a series of medical tests, but at first, no explanation was found for the deterioration. The pain worsened until he finally stopped walking completely. After an MRI, he was referred for further investigation at the day hospitalization department at Schneider Children's Medical Center.
"When we arrived at Schneider, he wasn't walking at all. If he wanted to go to the bathroom, I would take him. At home, we would lift him, and at the hospital, we moved around in a wheelchair," says his father. During the investigation, his parents shared another significant detail: for years, Nadav almost did not eat fruits and vegetables. "His diet is very monotonous. He would eat, for example, tuna, a cheese sandwich, and a cake, but we couldn't get him to eat vegetables. The fact that he is on the spectrum made it difficult for us to get him to eat things he didn't like," says the father.
The combination of the limited diet, leg pain, and bleeding gums led the doctors in a completely different direction. Dr. Ido Navon, a physician in the day hospitalization department at Schneider Children's Medical Center of the Clalit group, says that as soon as he saw Nadav, he suspected a severe vitamin C deficiency — and the disease scurvy.
"The first time I saw him, he was in a wheelchair and in a lot of pain. He is already the fourth child I meet on the spectrum with leg pain, who eventually turned out to be suffering from a vitamin C deficiency. When the parents mentioned his diet along with the bleeding gums, the dots connected. Many times the X-rays can look normal, but that doesn't mean the diagnosis was ruled out," he explains.
Scurvy is considered a fairly rare disease today. It is caused by prolonged malnutrition of vitamin C and is still discovered in people with eating disorders or those in difficult economic situations. According to Dr. Navon, scurvy can appear in children with a limited diet and significant food pickiness, including children on the autism spectrum. "In the department, we always ask about nutrition. It's a short question that can reveal important things to us," he says.
After the suspicion arose, tests were taken and Nadav immediately began receiving vitamin C, first intravenously and later orally. The improvement did not take long to arrive. "After two or three days, we already saw that it was helping the gums. After about a week and a half, he managed to stand," says his father. About a month after starting treatment, Nadav was already back to walking, and today his condition has improved to about 85%, with only a slight limp remaining.
"On one hand, you see a deterioration that brings a child to a state where he doesn't walk, and on the other hand, the treatment is so simple. He is already running and jumping." According to Dr. Navon, a severe and prolonged deficiency of vitamin C can damage bones and blood vessels. In rare cases of severe deficiency and significant delay in diagnosis, damage to the skeleton and growth plates and even tooth loss can occur.
Today, Nadav's parents are trying to gradually expand his menu. "We managed to convince him a little more to eat fruits and vegetables. We make sure he eats bell pepper, even if in small quantities. He asks me: 'Is it really because I didn't eat bell pepper?', and I have to explain to him why vitamin C is so important for the body."
