[Multiple epiphyseal separations in a child with cerebral palsy and scurvy].

Scurvy is a dietary disease due to Vitamin C deficiency. Vitamin C is related to collagen synthesis and metabolism. Malnutrition, problems in bowel absorption, alcoholism and cerebral palsy are clearly often linked with scurvy, even it is no more common in the industrialized countries. Its clinical features are: asthenia, weight loss, appetite decrease, irritability, gingival or mucous lesions, porpora, follicular hyperkeratosis, musculoskeletal pain due to multiple fractures and subperiosteal bleedings, pseudoparalisis (frog-like position of legs) and refuse to walk. Authors report on a nine year-old girl with spastic quadriplegic cerebral palsy, who at the first examination showed deep anemia, fever and multiple epiphyseal separation of the right shoulder and the left knee. Diagnosis of scurvy was been made. The aim of this article was to underline the rarity and gravity of this disease, and its even more frequent appearance in children affected of cerebral palsy. Substitutive therapy consists on ascorbic acid supplementation. Complete restitutio ad integrum of skin-mucous injuries, such as gingival bleedings, was achieved within three months.