Journal of pediatric gastroenterology and nutrition
September 17, 2026 · via Europe PMC
A nationwide multicenter observational study on childhood scurvy in Japan.
Masuda Y, Fukatsu R, Miyamoto R, +6 more, Okumura A.
AI summary — for doctors, generated from the abstract only
A nationwide Japanese study found that pediatric scurvy, though rare, occurs predominantly in children with selective diets related to autism spectrum disorder, often presents with gait disturbance rather than classic weight loss, and is frequently misdiagnosed or subjected to unnecessary invasive testing before the correct diagnosis is made.
What was studied
A two-step nationwide multicenter observational study in Japan, first screening 407 certified pediatric training hospitals to identify institutions that had treated children with scurvy between 2014 and 2023, then collecting detailed clinical, diagnostic, treatment, and outcome data via a follow-up questionnaire on identified cases.
Key findings
- Among 47 children with scurvy identified from 35 hospitals (median age 3.6 years, 70% male), 96% had a selective diet, 72% had autism spectrum disorder, and only 13% had no underlying condition; notably, only 36% had a body mass index standard deviation score below -2.0, meaning most children were not obviously malnourished by weight alone.
- The most common presenting symptom was gait disturbance (88%), while weight loss was observed in only 21% of patients; pretreatment serum ascorbic acid levels were below the detection limit in 77% of children tested.
- 30% of children were initially misdiagnosed, and 38% underwent potentially harmful or unnecessary diagnostic examinations before the correct diagnosis of scurvy was reached.
Clinical relevance
The findings suggest that clinicians evaluating children, especially those with autism spectrum disorder or other selective eating patterns, who present with unexplained gait disturbance should consider scurvy in the differential diagnosis even in the absence of visible malnutrition or weight loss, as careful dietary history-taking could help avoid misdiagnosis and unnecessary invasive testing.
Who should care
Limitations
This was a retrospective survey-based study relying on hospital-reported cases, which may undercount actual prevalence and depends on accurate recall and reporting by participating institutions.
Pediatric scurvy in Japan occurred mainly in children with selective diets linked to autism spectrum disorder, often presenting with gait disturbance rather than obvious malnutrition, and was frequently misdiagnosed, highlighting the importance of dietary history in unexplained gait symptoms.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objectives
Although scurvy is rare in developed countries, cases in children with selective diets due to neurodevelopmental disorders have been increasingly reported in Japan. In this nationwide multicenter observational study, we aimed to clarify the clinical characteristics and diagnostic challenges faced by children with scurvy in Japan.
Methods
We conducted a two-step nationwide multicenter observational study. An initial screening survey was sent to 407 training hospitals certified by the Japan Pediatric Society to identify institutions that had encountered children with scurvy between 2014 and 2023. A second, detailed questionnaire was sent to institutions that had managed children with scurvy, as well as those identified through a literature search, to collect data on clinical features, diagnostic processes, treatments, and outcomes.
Results
Forty-seven children with scurvy, from 35 hospitals were included in the final analysis. The median age was 3.6 years, 70% were male, and only 36% had a body mass index standard deviation score below -2.0. A selective diet was observed in 96% of patients; 72% had autism spectrum disorder (ASD), and 13% had no underlying disease. The most common presenting symptom was gait disturbance (88%), whereas weight loss was observed in only 21% of patients. Additionally, 30% were misdiagnosed, and 38% underwent potentially harmful examinations. Pretreatment serum ascorbic acid levels were below the detection limit in 77%.
Conclusions
In Japan, scurvy in children was predominantly associated with a selective diet, particularly among those with ASD. Careful dietary assessment is important to avoid diagnostic delay and irreversible complications.
DOI
10.1002/jpn3.70592
PMID
42755027
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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