Commentary on Progressive Motor Regression in a 3-Year-Old: Dietary Trends Revive an Overlooked Diagnosis

The authors share a very interesting and unexpected case of scurvy in a 3-year-old girl. It highlights not only the synergy of laboratory results and clinical context guiding diagnosis but also the need to carefully plan vegan diets for children. Since ancient times, scurvy has been recognized for bleeding gums and bleeding under the skin. In 1747, James Lind discovered that citrus fruit cured scurvy in what is believed to be the world’s first controlled trial (1). However, it was not until 1928 that the curative agent, vitamin C, was identified by Albert Szent-Györgyi (1). In modern times, scurvy is rarely seen in developed countries as citrus fruit, citrus juice, fortified food, and supplemental vitamin C are widely available. Nevertheless, low vitamin C intake and conditions that cause vitamin C malabsorption, increased utilization, or excretion can cause scurvy in any country. This makes it an important condition for laboratorians and clinicians to be aware of. Plant-based diets do not immediately come to mind as causes of scurvy. Fruits and some vegetables are excellent sources of vitamin C. However, as demonstrated by this case, even a vegan diet that excludes major sources of vitamin C can lead to deficiency—especially in the presence of malabsorptive conditions. Vegan and other plant-based diets are also generally less nutrient-dense than diets containing animal foods, which makes them more sensitive to omissions and restrictions, which can cause serious nutrient deficiencies. As such, vegan diets necessitate careful planning and often supplementation to ensure adequate growth and health of children (2). In coming years, these considerations will become more important due to growing public interest in the health benefits—and also environmental benefits—of plant-based diets. Clearly though, just because a diet is plant-based does not necessarily mean that it is healthy. The corresponding author takes full responsibility that all authors on this publication have met the following required criteria of eligibility for authorship: (a) significant contributions to the conception and design, acquisition of data, or analysis and interpretation of data; (b) drafting or revising the article for intellectual content; (c) final approval of the published article; and (d) agreement to be accountable for all aspects of the article thus ensuring that questions related to the accuracy or integrity of any part of the article are appropriately investigated and resolved. Nobody who qualifies for authorship has been omitted from the list. No authors declared any potential conflicts of interest.

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.