Résumé
The increase of published cases of paediatric scurvy alerts us to a resurgence of this pathology in France and other developed countries. Prevalence, which is certainly underestimated, would be higher than 0.05%, which does not make it a rare disease. Scurvy is defined by the combination of a biological vitamin C deficiency and aspecific clinical signs. Vitamin C, which is vital for the human body, is only supplied exogenously through the diet. General practitioners, who are in the front line of paediatric care, may lack knowledge of scurvy, which is difficult to diagnose. If the diagnosis is made late, the child may be exposed to serious complications, including death. Objective: ehe aim of this study was to update epidemiological, clinical, paraclinical and therapeutic data based on a cohort of French cases and a review of the literature on the subject in developed countries. Materiel & methods: we collected "PEDIASCORB" cases in French university hospitals, identified by the OSCAR network and the Société francophone de Rhumatologie et maladies inflammatoires pédiatriques (SOFREMIP) via REDCAP software. We also carried out a review of the international literature between 2011 and 2023, using the SUDOC, EmConsult and MedLine databases, as well as medical journals and newspapers from countries with a Human Development Index between 1 and 29. Results: 89 articles were used to extract data from 132 children with scurvy. The PEDIASCORB collection includes 19 new French cases not published in the literature. PEDIASCORB cases are younger, less symptomatic, less polypathological and less likely coming from specialized centers. Most of the children were seen in hospital and primary care. Scurvy affects boys (sex ratio 3.5: 1). They are autistic, have chronic pathologies and all have a restrictive diet or oral disorders. The symptoms are aspecific and multiple. The main symptoms are lameness, impairment of general condition and bleeding. Diagnostic delay is around 3 months, leading to many complementary examinations, many of which are invasives. Vitamin C testing is unnecessary and is not reimbursed on an outpatient basis. Once the diagnosis has been made, supplementation is 500 mg/day, with improvement in symptoms within 7-11 days. Conclusion: the cases from the PEDIASCORB collection are representative of those published in the literature. When faced with a child at risk of deficiency, the general practitioner should consider a balanced diet or preventive vitamin C supplementation. In the event of symptoms, therapeutic testing is a simple and inexpensive solution. GPs are at the heart of prevention and screening for nutritional deficiencies. This issue is part of the field of environmental health.