For­got­ten di­ag­no­sis helps child be­come mo­bile again

Doc­tors Find Vi­ta­min C De­fi­ciency

The Times of India (Mumbai edition) - - TIMES CITY -

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

50-100mg

of vi­ta­min C daily Tak­ing in less than

30mg

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.

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