Scurvy: An unusual presentation of cerebral palsy

Table 1 Laboratory investigation of the patient

Blood/serum	Patient’s value	Normal value
Hemoglobin	4.4 gm/dL	14.3-18.3 gm/dL
Total leucocytes count	7200	5.5-15.5 × 103 cells/µL
Differential count	Neutrophils 52.4%	54%-62%
	Lymphocytes 36.2%	25%-33%
Mean corpuscular volume	54.9	79.1-98.9 fL
Platelets	382 000	150-400 × 103 cells/µL
International normalised ratio	1.2	0.9-2.0
Serum calcium	9.8	8.4-10.8 mg/dL
Serum phosphorous	4.4	3.7-5.6 mg/dL
Serum alkaline phosphatase	197	145-420 IU/L

Table 2 Differential diagnosis of scurvy

Differential diagnosis
Child abuse and neglect
Medication side effects
Autoimmune diseases (e.g., henoch-schönlein purpura, systemic lupus erythematosus, sjogren syndrome)
Vitamin D deficiency and related disorders
Clotting factor deficiencies
Disseminated intravascular coagulation
Platelet dysfunction (e.g., immune thrombocytopenic purpura)
Senile purpura
Thrombophlebitis, deep venous thrombosis
Meningococcemia, rocky mountain spotted fever
Hematological malignancies (e.g., acute lymphoblastic leukemia)
Hypersensitivity vasculitis (leukocytoclastic vasculitis)
Necrotizing gingivitis
Osteomyelitis
Pediatric syphilis
Septic arthritis