MUSCULOSKELETAL MANIFESTATIONS OF PEDIATRIC SCURVY IN PATIENTS WITH RESTRICTED DIETS : CASE SERIES
DOI:
https://doi.org/10.31004/prepotif.v9i2.48481Keywords:
defisiensi vitamin C, laporan kasus, pola makan pseudoparalisis, selektif, skurvi, radiologi pediatrikAbstract
Kekurangan vitamin C (skurvi) merupakan kondisi yang jarang namun semakin sering ditemukan pada anak-anak dengan pola makan yang sangat selektif. Gejala awal meliputi kelelahan, perdarahan gusi, dan mudah memar. Pada tahap lanjut, gejala muskuloskeletal seperti pembengkakan anggota tubuh, nyeri, dan pseudoparalisis dapat menyerupai kondisi serius seperti osteomielitis atau keganasan sehingga diagnosis menjadi sulit. Kami melaporkan dua kasus pediatrik, yang pertama adalah seorang anak perempuan berusia 4 tahun 7 bulan dengan pembengkakan anggota tubuh bagian bawah yang progresif selama tiga bulan, kontraktur sendi, perdarahan gusi, anemia, dan penolakan berjalan. Kasus kedua adalah anak laki-laki berusia 5 tahun 2 bulan dengan demam berkepanjangan, pembengkakan kaki, ulkus mulut, dan pembatasan diet yang parah. Kedua anak sama-sama tidak mengonsumsi buah dan sayur. Pemeriksaan fisik menunjukkan keadaan malnutrisi, pseudoparalisis, dan gusi hiperemik yang rapuh. Temuan radiologi menunjukkan osteopenia, garis metafise yang padat (garis Frankel), fraktur sudut metafise, dan pergeseran epifise posterior. Tes kadar asam askorbat plasma tidak tersedia. Terapi vitamin C empiris memberikan perbaikan klinis yang cepat, termasuk hilangnya perdarahan, reversi pseudoparalisis, dan kemampuan berjalan kembali dalam dua minggu. Skuvi pediatrik harus dipertimbangkan pada anak dengan anemia tidak jelas, nyeri muskuloskeletal, dan tanda perdarahan, terutama jika riwayat diet menunjukkan pembatasan yang lama. Pengakuan dini dan suplementasi vitamin C dapat menghasilkan pemulihan penuh serta mencegah tindakan invasif.References
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