Scurvy hospitalizations have increased among children in US
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Key takeaways:
- Diagnoses increased from less than 0.5 per 100,000 hospitalizations in 2006 to more than four per 100,000 hospitalizations in 2021.
- Common comorbidities were autism and iron deficiency.
Hospitalizations for scurvy are on the rise among children in the United States, with a significant increase after 2017, according to data published in Pediatrics.
“Scurvy is an uncommon disease in children caused by nutritional deficiency of vitamin C,” Kathleen Murphy, DO, FAAP, pediatric hospitalist at The Children’s Hospital of Philadelphia, and colleagues wrote. “It can present with a variety of complaints, including joint swelling and tenderness, refusal to bear weight, rash, petechiae, bleeding, fever and irritability that may mimic more serious diagnoses and lead to unnecessary, costly and potentially harmful testing.”
Murphy and colleagues conducted a retrospective repeated cross-sectional study of 138 children (78% boys; median age, 7 years; interquartile range [IQR], 4-10 years) hospitalized for scurvy from 2006 to 2021 at 33 hospitals.
Hospitalizations for scurvy increased over time, with a significant uptick after 2017, the researchers wrote. In 2006, there were less than 0.5 scurvy diagnoses per 100,000 hospitalizations. There were nearly two scurvy diagnoses per 100,000 hospitalizations in 2017 and more than four diagnoses per 100,000 hospitalizations in 2021.
The median length of stay among children with scurvy was 5 days (IQR, 3-9 days), and the median cost was $17,082 (IQR, $10,211-$25,896).
“In 2017, the AAP updated their recommendations to further limit juice intake,” the researchers wrote. “As caregivers appropriately restricted juice, vitamin C may not have been replaced by other sources, especially in children with already selective diets.”
In addition to decreased juice intake, the researchers said disordered eating also could have contributed to the rise in cases.
The most common comorbidities reported were autism (60%), iron deficiency (43%) and other neurodevelopmental disorders (19%).
“Male predominance was also notable,” Murphy and colleagues wrote. “This finding may be related to autism epidemiology, but in post hoc analysis, males predominated in children both with and without autism or neurodevelopmental disorders.”
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