{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T14:36:30Z","timestamp":1777905390435,"version":"3.51.4"},"reference-count":15,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,5,25]]},"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>Vitamin C deficiency, historically known as scurvy, was associated with sailors in the Victorian times, however, a global review in 2020 suggests it still exists in certain at-risk groups.<\/jats:p>\n               <jats:p>A case is presented of a young non-verbal child with learning difficulties and on a restricted diet, in which the primary symptom was gingival inflammation. It posed a diagnostic dilemma due to the non-specific symptoms, and a delay in the diagnosis, until vitamin C deficiency was confirmed.<\/jats:p>\n               <jats:p>Gingival inflammation is one of the common findings in vitamin C deficiency and dental professionals may be the first point of contact. The importance of dietary evaluation, identifying and looking for other signs and liaising with the medical colleagues are discussed.<\/jats:p>\n               <jats:p>This case highlights the role of the dentist in identifying latent cases of vitamin C deficiency and to consider this as a differential diagnosis especially in certain at-risk groups.<\/jats:p>","DOI":"10.1136\/bcr-2022-249113","type":"journal-article","created":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T12:51:24Z","timestamp":1655729484000},"page":"e249113","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Scurvy presenting primarily as gingival manifestation in a young child: a diagnostic dilemma"],"prefix":"10.1136","volume":"15","author":[{"given":"Rashmi","family":"Chaluvaraj","sequence":"first","affiliation":[{"name":"Buckinghamshire Priority Dental Service, CNWL, Milton Keynes, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul F","family":"Ashley","sequence":"additional","affiliation":[{"name":"Paediatric Dentistry, UCL Eastman Dental Institute, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Parekh","sequence":"additional","affiliation":[{"name":"Paediatric Dentistry, UCL Eastman Dental Institute, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,6,20]]},"reference":[{"key":"2025082708345151000_15.6.e249113.1","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdn076"},{"key":"2025082708345151000_15.6.e249113.2","doi-asserted-by":"crossref","DOI":"10.3390\/nu12071963","article-title":"Factors affecting vitamin C status and prevalence of deficiency: a global health perspective","volume":"12","author":"Carr","year":"2020","journal-title":"Nutrients"},{"key":"2025082708345151000_15.6.e249113.3","doi-asserted-by":"crossref","unstructured":"Griffiths JK . Vitamin deficiencies. In: Magill AJ , Hill DR , Solomon T , et al , eds. Hunters tropical medicine and emerging infectious disease. Ninth Edition. Amsterdam: Elsevier BV, 2013: 997\u20131002.","DOI":"10.1016\/B978-1-4160-4390-4.00139-9"},{"key":"2025082708345151000_15.6.e249113.4","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114599001063"},{"key":"2025082708345151000_15.6.e249113.5","doi-asserted-by":"publisher","DOI":"10.1079\/BJN19970026"},{"key":"2025082708345151000_15.6.e249113.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2010.02.013"},{"key":"2025082708345151000_15.6.e249113.7","unstructured":"Maxfield L , Crane JS . Vitamin C Deficiency. In: Stat Pearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2020."},{"key":"2025082708345151000_15.6.e249113.8","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s40780-017-0088-5","article-title":"Drug-Induced gingival hyperplasia: a retrospective study using spontaneous reporting system databases","volume":"3","author":"Hatahira","year":"2017","journal-title":"J Pharm Health Care Sci"},{"key":"2025082708345151000_15.6.e249113.9","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1111\/ped.13160","article-title":"Food repertoire history in children with autism spectrum disorder in Japan","volume":"59","author":"Tanoue","year":"2017","journal-title":"Pediatr Int"},{"key":"2025082708345151000_15.6.e249113.10","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1111\/scd.12459","article-title":"The risk for scurvy in children with neurodevelopmental disorders","volume":"40","author":"Kothari","year":"2020","journal-title":"Spec Care Dentist"},{"key":"2025082708345151000_15.6.e249113.11","doi-asserted-by":"crossref","DOI":"10.1016\/j.pediatrneurol.2019.01.007","article-title":"Selective eating: a common Fuss in neurodevelopmental disorders","volume":"95","author":"Madaan","year":"2019","journal-title":"Pediatr Neurol"},{"key":"2025082708345151000_15.6.e249113.12","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1002\/aur.2500","article-title":"Eating disturbances in adults with autism spectrum disorder without intellectual disabilities","volume":"14","author":"Demartini","year":"2021","journal-title":"Autism Res"},{"key":"2025082708345151000_15.6.e249113.13","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-015-2660-x"},{"key":"2025082708345151000_15.6.e249113.14","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1007\/s11606-020-05636-1","article-title":"Clinical profile of scurvy in Hamilton since 2009: a cohort study","volume":"36","author":"Dadgar","year":"2021","journal-title":"J Gen Intern Med"},{"key":"2025082708345151000_15.6.e249113.15","doi-asserted-by":"crossref","first-page":"8323","DOI":"10.3390\/app11188323","article-title":"Oral manifestations in scurvy pediatric patients: a systematic review and a case report","volume":"11","author":"Gicchino","year":"2021","journal-title":"Appl Sci"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-249113","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:34:59Z","timestamp":1756308899000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-249113"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6]]},"references-count":15,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6,20]]},"published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1136\/bcr-2022-249113"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-249113","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6]]}}}