Abstract：
OBJECTIVE: We aimed to investigate the frequency of vitamin C deficiency scurvy in the Australian paediatric context, describe cohorts at risk, and identify factors associated with development of symptoms in children with vitamin C deficiency. We also aimed to propose a management guideline for children with features of scurvy.
METHODS: A retrospective study was done at a tertiary paediatric hospital in Australia over a three-year period, from August 2019 to July 2022. Children from birth to 18 years old, whose vitamin C levels were low (<23 μmol/L), were included. Data extracted from hospital medical records included demographics, weight, co-morbidities, eating disorder diagnoses, clinical features, investigations and treatment. Descriptive statistics and risk statistics were performed.
RESULTS: In a cohort of 887 patients who had their vitamin C levels checked, we identified 272 (31%) who had a vitamin C level <23 μmol/L. Of these, 13 (5%) were symptomatic of vitamin C deficiency and 19 (7%) may have been symptomatic. In patients with vitamin C deficiency, 248 (91%) had comorbidities, neurodevelopmental disorders being most common, and 176 (65%) had restricted eating. When the asymptomatic and symptomatic groups were compared, in the symptomatic group, there was a significantly lower vitamin C level and disordered eating related to autism spectrum disorders was more common.
CONCLUSIONS: In order to avoid delayed diagnoses and unnecessary investigations, clinicians should be familiar with symptoms of scurvy and perform a dietary assessment, vitamin C assay, and commence empiric vitamin C supplementation where appropriate.
METHODS: A retrospective study was done at a tertiary paediatric hospital in Australia over a three-year period, from August 2019 to July 2022. Children from birth to 18 years old, whose vitamin C levels were low (<23 μmol/L), were included. Data extracted from hospital medical records included demographics, weight, co-morbidities, eating disorder diagnoses, clinical features, investigations and treatment. Descriptive statistics and risk statistics were performed.
RESULTS: In a cohort of 887 patients who had their vitamin C levels checked, we identified 272 (31%) who had a vitamin C level <23 μmol/L. Of these, 13 (5%) were symptomatic of vitamin C deficiency and 19 (7%) may have been symptomatic. In patients with vitamin C deficiency, 248 (91%) had comorbidities, neurodevelopmental disorders being most common, and 176 (65%) had restricted eating. When the asymptomatic and symptomatic groups were compared, in the symptomatic group, there was a significantly lower vitamin C level and disordered eating related to autism spectrum disorders was more common.
CONCLUSIONS: In order to avoid delayed diagnoses and unnecessary investigations, clinicians should be familiar with symptoms of scurvy and perform a dietary assessment, vitamin C assay, and commence empiric vitamin C supplementation where appropriate.
摘要：
目的：我们的目的是调查澳大利亚儿科中维生素C缺乏症的发病率，描述处于危险中的队列，并确定与维生素C缺乏儿童症状发展相关的因素。我们还旨在为患有镰刀病的儿童提出管理指南。
方法：在澳大利亚一家三级儿科医院进行了为期三年的回顾性研究，从2019年8月到2022年7月。从出生到18岁的孩子，维生素C水平低（<23μmol/L），包括在内。从医院医疗记录中提取的数据包括人口统计，体重,合并症,饮食失调诊断，临床特征,调查和治疗。进行描述性统计和风险统计。
结果：在接受维生素C水平检查的887名患者中，我们确定了272（31％）的维生素C水平<23μmol/L。其中,13（5％）是维生素C缺乏的症状，19（7％）可能是有症状的。在维生素C缺乏的患者中，248（91%）有合并症，神经发育障碍是最常见的，176人（65%）限制进食。当比较无症状和有症状组时，在有症状的组中，维生素C水平显著降低,与自闭症谱系障碍相关的饮食紊乱更为常见.
结论：为了避免延误诊断和不必要的检查，临床医生应该熟悉镰刀病的症状，并进行饮食评估，维生素C测定，并在适当情况下开始经验性补充维生素C。
方法：在澳大利亚一家三级儿科医院进行了为期三年的回顾性研究，从2019年8月到2022年7月。从出生到18岁的孩子，维生素C水平低（<23μmol/L），包括在内。从医院医疗记录中提取的数据包括人口统计，体重,合并症,饮食失调诊断，临床特征,调查和治疗。进行描述性统计和风险统计。
结果：在接受维生素C水平检查的887名患者中，我们确定了272（31％）的维生素C水平<23μmol/L。其中,13（5％）是维生素C缺乏的症状，19（7％）可能是有症状的。在维生素C缺乏的患者中，248（91%）有合并症，神经发育障碍是最常见的，176人（65%）限制进食。当比较无症状和有症状组时，在有症状的组中，维生素C水平显著降低,与自闭症谱系障碍相关的饮食紊乱更为常见.
结论：为了避免延误诊断和不必要的检查，临床医生应该熟悉镰刀病的症状，并进行饮食评估，维生素C测定，并在适当情况下开始经验性补充维生素C。
