Causes and risk factors
Vitamin C is needed in collagen fibrogenesis, thus any deficiency will result in defective collagen formation and delayed wound healing. Barlow’s disease is caused due to deficiency of vitamin C. Lack of vitamin C in mother’s milk or in the formulated food on which the baby feeds can contribute to the causation.
Clinical presentation:
Onset is usually gradual. The complaints are seen both at mental and physical level. As vitamin C is needed for proper growth and development of the child, its deficiency can lead to interruption in the growth of the bones. Separation of epiphysis occurs. The ribs become prominent and sagging of sternum is seen. There occurs pain in the lower extremity and the legs are flexed. Loss of appetite is seen. At the mental level too, the complaints are seen. Child becomes irritable and lethargic. The child does not like to be touched and is cranky. Although rare deficiency of ascorbic acid can lead to hemorrhages under skin or hematuria can occur. Bruised skin, easy bruising, gum diseases, dry mouth, dry eyes are some of the other complaints commonly seen.
Investigations:
Diagnosis is done on the basis of the symptoms narrated by the parents and the physical examination carried out by the doctor. Certain investigations are advised for confirming the diagnosis. Capillary fragility test is diagnostic. X-ray of long bone is done. Along with this, routine blood test and test for serum vitamin C levels are done.
Treatment:
Change in diet of the mother or the baby is the first essential step which should be implemented. Diet should contain an adequate amount of vitamin C. Intake of foods rich in vitamin C is advised. Vitamin C supplements are started orally. Sodium ascorbate can also be given in the form of injections in certain cases.
Other Modes of treatment:
Certain other modes of treatment can also be helpful in coping up with the symptom. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints. Certain yoga exercises can also be helpful in strengthening the muscles.
