Forgotten diagnosis helps child become mobile again
Doctors Find Vitamin C Deficiency
Mumbai: A medical nightmare for the Guptas from Dahisar started in late July when their two-year-old son Ayan started complaining of knee pain. Over the next few weeks, he refused to move out of bed even as he folded his limbs in a “frog leg posture”.
“Soon, he seemed paralysed, unable to walk or even move his legs,” said his father, Vijendra Gupta (name changed on request). The family visited several doctors but did not receive a firm diagnosis. “He even underwent a bone marrow aspiration to rule out cancer,” he said.
Almost 75 days into the saga, doctors at Surya Hospital, Santacruz, came up with a forgotten diagnosis: Scurvy or severe deficiency of vitamin C. The condition was common over hundred years back among sailors and poor malnourished children who had no access to fresh fruits or vegetables, but urbanisation and progress changed that. People have more money and better access to healthier food options, at least in metro cities such as Mumbai.
But, as in Ayan’s case, inadequate intake of nutritious food and fussy eating could lead to severe deficiency. Moreover, as doctors don’t see cases of scurvy these days, the diagnosis isn’t the first thing that comes to mind. In fact, doctors in the private sector say they don’t see any cases, while doctors in public hospitals, the Help absorption of iron
Diet is main source of vitamin C. Citrus fruits, berries, peppers, broccoli, spinach, among others, contain vitamin C. Chewable tablets are an option too main healthcare option for poor, see a handful every year.
Pediatrician Dr Samantha Castellino said Ayan’s vitamin C levels were so low that blood tests could not measure it. “His parents told us Ayan would only have two types of meal a day — a porridge of dalhiya in the morning and afternoon, and rice khichdi in the evening,” she added.
The vitamin C component — citrus fruits or green vegetables — was missing from his diet, leading to scurvy. “We had to give him vitamin C intravenously for five days, but there was a visible change on the first day,” said pediatrician Sonal Saste from Surya Hospital. Ayan stopped folding his People need
of vitamin C daily Taking in less than
for a long period of time could cause deficiency legs in the frog leg posture, a tell-tale sign of scurvy. “The fact that the IV of vitamin C worked proved that this was the only problem with the child,” she added.
Dr Mukesh Agarwal, head of pediatrics at civic-run KEM Hospital in Parel, said scurvy is very rare these days. As KEM is a teaching and referral hospital, where cases from across the state come, it gets three to five cases a year. Pediatrician Mamta Manglani, who heads BMC’s special thalassemia care centre in Borivli, said scurvy has not completely gone away.
Vijendra said Ayan, discharged on September 5, stopped complaining of pain.