PDF(Pubmed)
Abstract：
BACKGROUND: Scurvy is an uncommon disease in developed countries caused by deficiency of vitamin C. We present a case of scurvy in a 14-year-old male with autism with both novel presentation and imaging findings. This case had the novel presentation of lower limb deep vein thrombosis (DVT) secondary to compression of the external iliac vein from large bilateral iliac wing subperiosteal hematomas. Subperiosteal hematoma is a well-recognised feature of scurvy but large and bilateral pelvic subperiosteal hematoma causing DVT has not previously been described.
METHODS: A 14 year old Caucasian male with background of autism and severe dietary restriction presented with lower limb swelling and immobility. He was diagnosed with lower limb DVT. Further investigation revealed an iron deficiency anaemia, and he was found on MRI to have large bilateral subperiosteal iliac hematomata causing compression of the iliac vessels. He improved following treatment with vitamin C replacement and follow-up imaging demonstrated resolution of the DVT and hematoma.
CONCLUSIONS: DVT is rare in children and when diagnosed should prompt investigation as to the underlying cause. This case demonstrates an unusual cause of DVT and as an unusual presentation of paediatric scurvy.
METHODS: A 14 year old Caucasian male with background of autism and severe dietary restriction presented with lower limb swelling and immobility. He was diagnosed with lower limb DVT. Further investigation revealed an iron deficiency anaemia, and he was found on MRI to have large bilateral subperiosteal iliac hematomata causing compression of the iliac vessels. He improved following treatment with vitamin C replacement and follow-up imaging demonstrated resolution of the DVT and hematoma.
CONCLUSIONS: DVT is rare in children and when diagnosed should prompt investigation as to the underlying cause. This case demonstrates an unusual cause of DVT and as an unusual presentation of paediatric scurvy.
摘要：
背景：在发达国家，镰刀症是一种由维生素C缺乏引起的罕见疾病。我们介绍了一例14岁男性自闭症的镰刀病病例，具有新的表现和影像学表现。该病例出现了新的下肢深静脉血栓形成（DVT），继发于双侧髂翼骨膜下血肿压迫外静脉。骨膜下血肿是已知的镰刀病特征，但以前尚未描述过引起DVT的大型和双侧骨盆骨膜下血肿。
方法：一名14岁白人男性，患有自闭症和严重的饮食限制，表现为下肢肿胀和不活动。他被诊断为下肢DVT。进一步调查显示缺铁性贫血,MRI发现双侧骨膜下髂骨大血肿导致髂血管受压。他在接受维生素C替代治疗后有所改善，随访影像学显示DVT和血肿的分辨率。
结论：DVT在儿童中很少见，诊断时应及时调查其根本原因。此病例显示了DVT的异常原因，并且是儿科镰刀病的异常表现。
方法：一名14岁白人男性，患有自闭症和严重的饮食限制，表现为下肢肿胀和不活动。他被诊断为下肢DVT。进一步调查显示缺铁性贫血,MRI发现双侧骨膜下髂骨大血肿导致髂血管受压。他在接受维生素C替代治疗后有所改善，随访影像学显示DVT和血肿的分辨率。
结论：DVT在儿童中很少见，诊断时应及时调查其根本原因。此病例显示了DVT的异常原因，并且是儿科镰刀病的异常表现。
