The North American epidemic of overeating, combined with a sedentary lifestyle, has led to a growing prevalence of obesity, diabetes, and the “metabolic syndrome” in children. Excessive caloric intake does not imply adequate nutrition, and vitamin-deficiency syndromes still occur in some American children. Here we describe cases of scurvy and vitamin D deficiency in 2 children with cognitive disorders. Thorough dietary histories suggested the diagnosis in each patient and, had they been obtained at presentation, would likely have obviated invasive diagnostic workup, unnecessary stress to the patients and their families, and significant functional disability. Overnutrition and malnutrition may coexist, particularly among those with abnormal cognition or autistic spectrum disorders. Classic nutritional deficiencies must not be omitted from the differential diagnosis. A comprehensive dietary history and screening for vitamin deficiencies in at-risk children are important aspects of preventive health care and are essential for prompt diagnosis and treatment.
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March 2007
Experience & Reason|
March 01 2007
Scurvy and Rickets Masked by Chronic Neurologic Illness: Revisiting “Psychologic Malnutrition”
James McCallum Noble, MD;
James McCallum Noble, MD
aDepartments of Neurology
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Arthur Mandel, MD, PhD;
Arthur Mandel, MD, PhD
aDepartments of Neurology
bPediatrics, Morgan Stanley Children's Hospital of New York and the Neurological Institute of New York, Columbia University Medical Center, New York, New York
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Marc C. Patterson, MD, FRACP
Marc C. Patterson, MD, FRACP
aDepartments of Neurology
bPediatrics, Morgan Stanley Children's Hospital of New York and the Neurological Institute of New York, Columbia University Medical Center, New York, New York
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Address correspondence to James McCallum Noble, MD, Department of Neurology, Neurological Institute of New York, Columbia University Medical Center, 710 W 168th St, New York, NY 10032. E-mail: jn2054@columbia.edu
Pediatrics (2007) 119 (3): e783–e790.
Article history
Accepted:
September 22 2006
Citation
James McCallum Noble, Arthur Mandel, Marc C. Patterson; Scurvy and Rickets Masked by Chronic Neurologic Illness: Revisiting “Psychologic Malnutrition”. Pediatrics March 2007; 119 (3): e783–e790. 10.1542/peds.2006-1071
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