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Vitamin C Case Study Review

February 13, 2018

Olivia C. Applegate
“Scurvy: When it is a Forgotten Illness, the Surgery Makes the Diagnosis” Review

According to this case study, a 4-year-old girl with cerebral palsy had been diagnosed

with infectious colitis, and osteomyelitis before entering an operation that determined she

actually had scurvy due to malnutrition. The child was put on an oral supplementation regimen

of Vitamin C for three weeks until her symptoms improved. Though cases of scurvy are rare

even in developing countries, there are some higher reports of the disease in certain

communities; such as the elderly, people with psychiatric afflictions, and those with chronic

neurological pathologies. This is mainly due to their tendency to have limited food preferences

and a common gravitation toward repetitious routines.

Vitamin C cannot be converted from glucose in the human body, therefore we must

consume ascorbic acid via an exogenous source. It is required for collagen formation and tissue

repair, and is important in redox reactions inside the body as well. The most prominent

function of Vitamin C is collagen formation. When a person is deficient in ascorbic acid, it can

loosen the proteins that bond collagen together, causing bleeding. Since we know the patient

was taken to the hospital after blood was found in her stool, it is easy to predict she had been

suffering from a very severe case of Vitamin C deficiency, causing her gastrointestinal tract to

begin bleeding. It is also very possible that this patient was suffering from anemia since the

relationship between Vitamin C and Iron are quite dependent.

This 4-year-old was first diagnosed with osteomyelitis, which is also not unexpected.

Ostensibly, major symptoms or side effects or pediatric scurvy are musculoskeletal

manifestations such as: arthralgia (joint pain), myalgia (muscle pain), hemarthrosis (bleeding

into joint spaces), muscular hemorrhage, and subperiosteal hematomas. This patient ended up

having two of these symptoms and was then diagnosed with scurvy upon further investigation

of her diet. Once the surgeons found no infection in the hematoma, they questioned the

mother about her food intake. Shockingly, this mother had been continuing to only feed this 4-

year-old milk as if she was an infant, probably causing more than one malnutrition-based


In personally knowing people with autism and cerebral palsy, I found this very

concerning and interesting because I DO know them to each be “picky eaters.” The people I

know personally are not as drastically adverse to vegetables as this 4-year-old seemed to be,

but of course everyone is different and there are many levels and layers to the neurological

spectrum. I decided to look into this topic further and found many academic articles relating to

malnutrition and children with special neurological situations. For instance, it is extremely

common for children on the autism spectrum to portray food selectivity and sensory sensitivity.

Obviously, this leads to the serious truth that scurvy is not the only disease that can arise from

these cases of malnutrition.

In addition to those with neurological dysfunctions, I wanted to research others who

may be hindered nutritionally. Just after reading the abstract to this case study, I immediately

thought of an episode of one of my favorite television shows, “The Unbreakable Kimmy

Schmidt.” The show takes place in New York City, and in this particular episode one of the
characters has been sick with a fever for longer than normal. One of the main themes of the

show is the fact that these characters do not have much money and are barely scrapping by.

This character finally finds out he has scurvy because he lives in a food desert and doesn’t have

easy access to fresh produce. This show is a comedy; and obviously I know that food desserts

are a true issue, but I did not take this episode to heart initially. At least not until I read this

particular case study and my horizons were broadened slightly.

I know we would see many more reports of scurvy, rickets, and other nutrition-related

diseases in food desserts if situations were this dire, but perhaps we are overlooking the

seriousness of acute malnutrition in certain parts of the world. I feel many of my peers would

agree that many people in the US do not get proper food education. These thoughts, case

studies, and articles just reiterate the importance of proper nutrition and the significance of not

allowing symptoms to be overlooked.

Works Cited

“Kimmy Steps on a Crack!” Unbreakable Kimmy Schmidt: Season Three, written by Tina Fey and

Robert Carlock, Netflix, NBC Universal, 2015.