Abstract：
Scurvy is a well-known clinical condition caused by vitamin C deficiency. Although considered a rare disease in high-income countries, it has been recently increasingly reported in children, especially in those with abnormal dietary habits, mental or physical disabilities. We performed an extensive review of the literature analyzing studies published in the last 20 years focusing on clinical features, differential diagnosis and diagnostic delay. Fifteen articles were selected, collectively reporting a total of 166 children. Because of the wide clinical spectrum (musculoskeletal complaints and/or mucocutaneous lesions or systemic symptoms), scurvy can mimic several conditions, including autoimmune diseases, infections, and neoplasia. In addition, frequent findings such as normal nutritional status, anemia or elevated inflammatory markers may guide clinicians towards the abovementioned misdiagnoses. Scurvy should be considered in patients presenting with musculoskeletal complaints, not only in those with risk factors but also in healthy children. A focused dietary history and a careful physical examination, assessing other signs of vitamin C deficiency, are mandatory in these patients. When suspected, the dosage of serum vitamin C is the diagnostic gold standard; furthermore, imaging studies, performed by an expert radiologist, can reveal the typical features of scurvy. Only early diagnosis can avoid unnecessary investigations and potentially fatal complications of the disease.
摘要：
镰刀是一种众所周知的由维生素C缺乏引起的临床疾病。尽管在高收入国家被认为是一种罕见的疾病，最近在儿童中越来越多的报道，尤其是那些饮食习惯异常的人，精神或身体残疾。我们对过去20年发表的文献进行了广泛的回顾，重点是临床特征，鉴别诊断和诊断延迟。选择了15篇文章，总共报告了166名儿童。由于广泛的临床范围（肌肉骨骼不适和/或皮肤粘膜病变或全身症状），镰刀可以模仿几个条件，包括自身免疫性疾病,感染,和瘤形成。此外,频繁的发现，如正常的营养状况，贫血或炎症标志物升高可指导临床医生进行上述误诊.在患有肌肉骨骼疾病的患者中，应考虑是否患有镰刀。不仅在那些有危险因素的人中，而且在健康的儿童中。有重点的饮食史和仔细的体格检查，评估维生素C缺乏的其他迹象，在这些患者中是强制性的。当被怀疑时，血清维生素C的剂量是诊断的金标准；此外，影像学检查,由放射科专家执行，可以揭示的典型特征。只有早期诊断才能避免不必要的检查和潜在的致命并发症。
