Scurvy as a differential diagnosis of chronic pain in the lower limbs in a patient with autism spectrum disorder (ASD): a narrative review of the literature
Abstract
Case Presentation: AGRB, male, 9 years old, 52kg, previously healthy, born and raised in Pirambu, Bebedouro village, Sergipe.Adtted on 10/09/2022 to the pediatrics sector of the Sergipe Emergency hospital, reporting headache, fever and vomiting for 7 days, with subsequent evolution with pain in the posterior region of the right thigh, in addition to low back pain.Physical examination showed normal breathing and heart rate.Decreased strength in lower limbs, being worse on the left side.No patellar reflex and left Achilles.Normal right reflexes.Strength preserved in upper limbs.Presence of Babinski's sign on the right.No signs of trunk involvement.During the medical evaluation, a magnetic resonance imaging (MRI) of the dorsal column was requested, with findings of multiple foci with heterogeneous gadolinium uptake affecting the central portion and anterior funiculi of the spinal cord from D8 to the medullary cone, with T2 hypersignal in the spinal cord parenchyma adjacent and extending to the D4 level, with mass effect, with partial erasure of the CSF column in correspondence.The vertebral bodies, joints and musculature had normal contours and structures.It was concluded, then, that the examination showed an inflammatory-type lesion with a focus on schistosomiasis with involvement of the spinal cord associated with epidemiological data and clinical suspicion.Collected CSF that showed total proteins in the amount of 128.6 mg/dL, 597 cells/ mm3 (PNM: 14% and LMN: 86%) with…
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