Tissue scurvy misdiagnosed as child abuse

Background: It is postulated that Tissue Scurvy is a disorder in a genetically susceptible child in whom the cellular uptake of Vitamin C is inhibited following pancreatic β cell destruction causing Insulin deficiency. Insulin is required for the transfer of Vitamin C and Glucose into the cell for efficient cellular function.  Failure of this process causes Tissue Scurvy which is mistaken for Non-accidental Injury (Shaken Baby Syndrome) with serious consequences for the care giver.
Method: A child presenting with the signs and symptoms suggestive of Non-accidental injuries was investigated for evidence of insulin deficiency and Liver dysfunction.
Result: It was found that there was evidence of hyperglycaemia, implying insulin deficiency, and Liver dysfunction, as shown by abnormal liver function tests. Liver dysfunction implies defective γ-carboxylation of the Coagulation Factors II, VII, IX and X and the bone forming proteins Osteocalcin and matrix Gla Protein thus predisposing to spontaneous bleeding and fractures.
Conclusion: Tissue Scurvy is an autoimmune disorder in a genetically susceptible child resulting from destruction of the β cells of the Pancreas which causes insulin deficiency and failure of the cellular uptake of Vitamin C and Glucose. Hyperglycaemia and Liver dysfunction are constant biochemical findings and bleeding and fractures common and can be mistaken for child abuse. Viral, bacterial and parasitic infections may initiate the process.