A 3-Year-Old With Gingival Hemorrhage and Musculoskeletal Pain

A 3-year-old boy presented to the dental office with gum bleeding and musculoskeletal pain. He had dark spots on his gums and bleeding during teeth brushing. He also developed a limp in his right leg and had difficulty standing up. The pediatrician diagnosed him with transient synovitis of the hip. However, the patient's symptoms worsened, with spontaneous gingival bleeding and increased limb weakness. The correct diagnosis was scurvy, a vitamin C deficiency. Spontaneous gingival hemorrhage and limb weakness are characteristic manifestations of scurvy. Treatment involves checking the plasma level of vitamin C and administering high-dose vitamin C. Prompt resolution of symptoms after treatment confirms the diagnosis. Scurvy can occur due to limited access to fruits and vegetables or certain medical conditions. Early diagnosis is crucial to prevent complications. The patient's symptoms improved after starting vitamin C supplementation and incorporating more fruits and vegetables into his diet.