Document Detail

Pulmonary Hypertension Associated With Scurvy and Vitamin Deficiencies in an Autistic Child.
MedLine Citation:
PMID:  24190688     Owner:  NLM     Status:  Publisher    
Restricted dietary intake is common among children with behavioral issues. Here we report a case of a severely autistic child who presented initially with limp but who soon developed cough, tachypnea, hypoxia, and tachycardia. An echocardiogram revealed evidence of pulmonary hypertension (PH) with severely dilated right ventricle and elevated right-sided pressures. The etiology of his PH was unclear but further laboratory evaluation demonstrated severe nutritional deficiencies, in particular an undetectable ascorbic acid (vitamin C) level as well as deficient levels of thiamine (vitamin B1), pyridoxine (vitamin B6), cobalamin (vitamin B12), and vitamin D. Repletion of these vitamins was associated with resolution of his PH and his musculoskeletal complaints. We report this case and a review of the relevant literature as a clinical lesson to expand the differential diagnosis of limp in children who may be difficult to assess as well as to report on an unusual association between severe vitamin deficiencies and PH.
Melody G Duvall; Yana Pikman; David B Kantor; Katelyn Ariagno; Lisa Summers; Theodore C Sectish; Mary P Mullen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-11-4
Journal Detail:
Title:  Pediatrics     Volume:  -     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2013-11-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Division of Critical Care Medicine, Department of Anesthesia.
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