19 July 2023
: Case report 
Unusual Presentation of Pediatric Scurvy: A Necrotic Gastrostomy Tube Site in a 14-Year-Old Boy
Unusual clinical course, Challenging differential diagnosis, Rare disease
Nicholas R. Zessis
1ABCDEF*, Sarah W. Peters2BCDE, Jonathan D. Samet3CDE, Simon Parzen-Johnson1BCDE, Laura T. Russo4BCDE, Waheeda Samady1ACDE, Rebecca Stephen1ACDE
DOI: 10.12659/AJCR.940770
Am J Case Rep 2023; 24:e940770
Table 1. Vital signs and laboratory tests obtained at initial presentation.
| Test and unit | Reference range | Value |
|---|---|---|
| Temperature, °C | 35.5–37.5 | 36.7 |
| Heart rate, bpm | 60–100 | |
| Respiratory rate, breaths/min | 12–20 | 22 |
| Blood pressure, mmHg | 110–131/64–83 | 124/ |
| Oxygen saturation, % | 95–100 | 98 |
| Calcium, mg/dL | 8.8–10.8 | 9.6 |
| Magnesium, mg/dL | 1.8–2.4 | 2.0 |
| Phosphorous, mg/dL | 3.0–4.8 | 3.8 |
| Sodium, mEq/L | 136–149 | |
| Potassium, mEq/L | 3.9–5.7 | 4.2 |
| Chloride, mEq/L | 98–108 | 99 |
| Carbon dioxide, mEq/L | 23–30 | |
| Glucose, mg/dL | 70–100 | |
| Blood urea nitrogen (BUN), mg/dL | 7–18 | 9 |
| Creatinine, mg/dL | 0.25–1.24 | |
| Total protein, g/dL | 6.4–8.3 | 7.3 |
| Albumin, g/dL | 3.6–4.7 | |
| Total bilirubin, mg/dL | 0.2–1.0 | 0.5 |
| Alkaline phosphatase, IU/L | 74–318 | 187 |
| Alanine aminotransferase, IU/L | 2–30 | 13 |
| Aspartate aminotransferase, IU/L | 18–57 | 20 |
| White blood cells per µL | 4.5–13.5×10 | 7.32 |
| Red blood cells per µL | 4.1–5.1×10 | 4.69 |
| Hemoglobin, g/dL | 12–16 | 12.1 |
| Hematocrit,% | 36–46 | 37.3 |
| MCH, pg | 25–35 | 25.8 |
| MCV, fL | 78–98 | 79.5 |
| Platelets per µL | 150–450 | 381 |
| Neutrophils,% | 34–64 | |
| Lymphocytes,% | 25–45 | |
| Prothrombin time, sec | 9.3–12 | 11.4 |
| International normalized ratio | – | 1.10 |
| Activated partial thromboplastin time, sec | 23.6–30.7 | 24.4 |
| Fibrinogen, mg/dL | 180–410 | |
| D-dimer, mcg/mL | <0.50 | |
| ESR, mm/hr | 0–20 | 5 |
| CRP, mg/dL | 0–0.8 | |
| pH | 7.35–7.45 | 7.43 |
| Lactate, mEq/L | 0.5–2.2 | 1.6 |
| Protein | Negative | Negative |
| Blood | Negative | |
| Blood | No growth | No growth |
| Urine | No growth | No growth |
| SARS-CoV-2 nasal swab | Negative | Negative |
| values indicate an abnormal result. Units: °C – degrees Celsius; bpm – beats per minute; mmHg – millimeters mercury; mg/dL – milligrams per deciliter; mEq/L – milliequivalents per liter; g/dL – grams per deciliter; IU/L – international units per liter; µL – microliter; pg – picograms; fL – femtoliters; sec – second; mcg/mL – micrograms per milliliter; mm/hr – millimeters per hour. | ||