Background and aims: Scurvy is still reported worldwide. We studied its manifestations in Thai children.
Methods: This study was conducted at Siriraj Hospital, Mahidol University. Medical and radiographic records of 1- to 13-year-old children with scurvy during 2000 to 2017 were analyzed. Subjects were categorized into: (i) symptomatic vs. asymptomatic, and (ii) diagnosis in years 2000-2008 vs. years 2009-2017
Results: Forty subjects (median age 3.6 years) were enrolled, 34 (85%) symptomatic and 6 (15%) asymptomatic. Their nutritional status were 55% normal, 25% wasting, and 20% overweight or obesity. They ate little fruits and vegetables, and drank large amount of UHT cow's milk and soy drink. In years 2009-2017 group, 24 (out of 28) had symptoms, which were indistinguishable from years 2000-2007 (10 of 12). In years 2009-2017 group, one subject had unusual manifestations of convulsion and epidural hemorrhage. Roentgenography of lower extremities of the symptomatic group was performed in 26 out of 34 subjects; 25 showed abnormal results, compared to 1 in the asymptomatic group (P=0.019). Serum vitamin C levels were analyzed in 23 of the symptomatic group and 3 (out of 6) of the asymptomatic group; prevalence of abnormal results were not different. All subjects without serum vitamin C tests showed abnormal x-ray findings too. After treatment, gum and skin bleeding resolved within 7-8 days, and difficult walking resolved within 20 days. Fruit and vegetable consumption was improved (P=0.000).
Conclusions: Half of 40 pediatric scurvy cases during 18 years had normal nutritional status. Favorable outcomes were achieved after treatment.

PEDIATRIC SCURVY IN THAILAND: A CASE SERIES AT SIRIRAJ HOSPITAL, MAHIDOL UNIVERSITY