Is it Child Abuse – Or, Something Else Entirely?

By Susan Pearce

This was printed in the December, 2004, issue of The Paramedic, a British magazine of the Ambulance Services Benevolent Fund, of England.

Often a child will be thought to have been abused, when in fact low vitamin C stores, combined with the stresses of vaccination or infection, may have produced the physical signs suggesting abuse. Bruising, subdural hematoma, brain swelling, retinal hemorrhages, and even rib fractures are all signs of severe vitamin C deficiency, or infantile scurvy; but the need for blood vitamin C analysis and appropriate treatment may not be appreciated.

A recent article by C. Alan B. Clemetson, M.D., [1] described signs like retinal petechiae, subdural hemorrhages, and broken bones, often thought to be indications of child abuse or trauma.  He believes that these signs could be a result of a variant form of Barlow’s disease.

Dr. Clemetson stated that histamine levels are increased when a person has low levels of vitamin C.  The high histamine levels become markedly increased because of infection or the injection of foreign proteins.  He said that these high blood histamine levels due to infections or vaccinations in vitamin C-deficient infants can cause a variant of Barlow’s disease, or infantile scurvy.  This causes “weakness of the retinal vessels and the bridging veins and venules between the brain and the dura mater in infants.”

Clemetson explained that for the first 75 years of the last century, Barlow’s disease was known to be characterized by broken bones, bruises, and sores that wouldn’t heal.  This disease was found in bottle-fed infants whose mothers did not supplement their babies’ diets with orange juice as a source of vitamin C.  Infants whose mothers boiled cow’s milk also suffered from scurvy because boiling destroyed vitamin C in the milk.

Dr. Clemetson discussed two papers written by two early shaken baby syndrome researchers, J. Caffey [1946] and H. Kempe [1962], in which both mentioned that the children that were considered battered could possibly have been suffering from infantile scurvy, a vitamin C deficiency disease.

Clemetson felt that one reason that current researchers do not mention vitamin C deficiency in relation to shaken baby syndrome might be the erroneous belief that people no longer become vitamin C deficient.  Since infants do not show signs of scurvy in their gums as adults do, it is difficult to clinically diagnose infants with scurvy.  He said that laboratory analysis for plasma ascorbic acid or blood histamine levels is hardly ever done before making the diagnosis of shaken baby syndrome.

Barlow’s disease can be caused not only by a deficient intake of vitamin C in the diet, but also by infections and wounds that tend to rapidly deplete the body’s stores of vitamin C.  Other causes of low vitamin C that Clemetson listed include “trauma, surgery, cigarette smoke, hemolysis, heavy metals, and many drugs such as fenfluramine.”

He said that Barlow’s disease can also result from malnutrition in the mother, by excessive vomiting during her pregnancy, and by infections in the mother and/or in the infant.

Dr. Clemetson explained how even mild depletion of vitamin C can cause histamine levels in the blood to become elevated, which in turn causes capillaries to become fragile.  This capillary fragility is a common characteristic of scurvy.

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