By Michael D Innis MBBS;DTM&H;FRCPA;FRCPath
Retired Haematologist
Princess Alexandra Hospital
Brisbane, Australia
Dr. Innis gave permission for reprinting this paper here. It is published at
Clinical Medicine Research
Volume 2, Issue 6, November 2013, Pages: 154-157
Received: Oct. 2, 2013; Published: Nov. 10, 2013
Tissue Scurvy is an autoimmune disorder in which Vitamin C is unable to enter cells because of the lack of Insulin resulting in disruption of cellular function. Vitamin C functions as an antioxidant blocking the damage caused by free radicals, a product of cellular metabolism, and ensures normal cellular function. Tissue Scurvy is the result of a failure of this process.
Key Words: Autoimmunity, Tissue Scurvy, Encephalomyelitis, Non-accidental Injury, Shaken Baby Syndrome
Abstract
Requests from distressed parents and relatives seeking help after having been accused of injuring their children are not uncommon. Viral, parasitic infections and vaccines cause an autoimmune disorder, Tissue Scurvy, misdiagnosed as child abuse and this report presents the evidence. Method. Relevant hospital and laboratory reports of three children were examined for evidence of Tissue Scurvy as the cause of the neurological lesions, fractures, bruises and haemorrhages found on them. Results. In all the cases in which appropriate histories and tests were done there was evidence that the laboratory evidence was ignored or doctors were unaware of the significance of abnormal tests suggesting Tissue Scurvy as the cause of the problems. Conclusion. Tissue Scurvy, absence of Vitamin C within the cell in the body, is a autoimmune reaction resulting in extensive lesions misdiagnosed as Non-accidental Injury.
Introduction
At a conference on Encephalitis held in Cardiff in 1928 [1] the Pathologist Hubert Turnbull stated “I understand that the primary subject of the discussion is the nature of encephalomyelitis following vaccination. It is no longer necessary to argue that an encephalomyelitis is sometimes a complication of vaccination. The exact cause of the encephalomyelitis need only be discussed.”
A plausible explanation for the encephalomyelitis following vaccination which Hubert M Turnbull sought to address is provided by the work of Wakefield et al; who showed Urinary Methylmalonic Acid was significantly raised in all eight children vaccinated with the MMR vaccine who were tested, compared with age-matched controls (p=0•003) [2].
Raised urinary methylmalonic acid is a confirmatory test for Vitamin B12 deficiency [3]. A deficiency of Vitamin B12 is the result of an autoimmune reaction[4] destroying the parietal cells in the stomach thereby inhibiting the uptake of Vitamin B12 in the diet.
“Shaken Baby Syndrome or Vaccine Induced Encephalitis” was the subject of an extensive review by Buttram [5] where he draws attention to the work of others on the subject of demyelination of the central nervous system following the adminstration of vaccines.
The suggestion by Yazbak that an autoimmune reaction was the basis of adverse vaccine reactions anticipated subsequent observations [6] and proved to be correct He stated, “resuming routine vaccination of the newborn period with a Thiomerosal – free vaccine will not be prudent, as the reported reactions seem auto-immune, and do not suggest a heavy metal poisoning”. [7]
Yazbak’s suggestion of an autoimmune reaction and that of Herroelen, de Keyser and Ebinger [8] who reported 2 patients had neurological symptoms and signs, with evidence of central-nervous-system demyelination, 6 weeks after administration of recombinant hepatitis B vaccine suggesting the time interval would fit a proposed immunological mechanism is further explored here.
The late Dr Archie Kalokerinos was the first to point out that Scurvy was the cause of what doctors were calling Shaken Baby Syndrome. In his book, Every Second Child, he said, “during one trial the prosecution said scurvy was no longer seen. I replied – “yes it is, but it is not called ‘scurvy’ it is called Shaken Baby Syndrome”[9]. By reducing or delaying immunization he was able to reduce the mortality in infants.
Tissue Scurvy, unlike the “Seafarer Scurvy” of yesteryear, is a condition in which Vitamin C is abundant in the blood but is unable to enter the cell because of a lack of Insulin which is required to transfer the Vitamin C into the cell.
Normally insulin binds to its receptor on the cell surface and initiates a chain of events that leads to the insertion in the plasma membrane of a trans membrane glucose transporter called GLUT 4 which facilitates the transport of Vitamin C, glucose and other nutrients into the cell [10]. Within the cell Vitamin C functions as an antioxidant blocking the damage caused by free radicals, a product of cellular metabolism, and ensures normal cellular function. Tissue Scurvy is the result of a failure of this process.[11]
Tissue Scurvy involving the liver cells (hepatocytes) leads to under carboxylation of the extrinsic coagulation factors and osteocalcin resulting in bruises, haemorrhages, fractures and encephalopathy [12] – the so-called “triad” of Non-accidental Injury.
When Tissue Scurvy involves the parietal cells of the stomach it leads to the failure of the production of Intrinsic factor and hence failure of absorption of Vitamin B12 in the diet.
Besides neurological lesions the many faces of Tissue Scurvy in Childhood include the diagnoses Sudden Infant Death Syndrome, Non-accidental Injury, Shaken Baby Syndrome, Abusive Head Trauma, Inflicted Brain Injury, Reye’s Syndrome, Kawasaki Disease, Anaphylaxis and Diabetes Type 1.[13].
All have one feature in common – hyperglycaemia, the signature of Insulin deficiency resulting from vaccines, and other forms of antigenic stress which damage the Beta cells of the Islets of Langerhans resulting in hypoinsulinaemia and Tissue Scurvy.
Regrettably doctors in the English speaking world are taught “abused infants may have bleeding around the brain and in the eyes – the hallmarks of SBS but most also bear signs of the violence which killed them, fractures, bruises, burns, malnutrition or neglect”[14].
Adding to the problem is “the American justice system is not designed to determine scientific truth but, rather, to balance contested facts and bring closure to a dispute ”[15], and the systems in the UK, Australia, Canada and New Zealand would appear to be similarly afflicted.
It is precisely this failure to seek the truth that is destroying hundreds, perhaps thousands of lives and the American justice system and others are urgently in need of change.
Reviewed here are some instances in which a father, family member, or caretaker has been accused of causing the death of an infant or child from Shaken Baby Syndrome while the true cause of death was an autoimmune reaction.
Doctors making these accusations ignore the fact that Haemostasis and Osteogenesis require the carboxylation of some Clotting factors and Osteocalcin, a process which takes place in the liver and which is impaired in Tissue Scurvy. Tests for Liver Function are done but the results when abnormal are completely ignored or their significance misunderstood and the unfortunate parent bears the consequences of the error.
Case Report 1.
John, not his real name, was the second child of a 34-year-old mother who suffered from
severe morning sickness for about 5 months of her pregnancy which lasted 9 months. A forceps delivery was necessary and the infant weighed 3860 gm. There was some bruising on the left side of the face possibly from the forceps. Apgar scores were 8 an 9 at 1 and 5 minutes. Vitamin K was given by intramuscular injection.
The infant was both breast and formula fed for 3 weeks and then given formula only. He was circumcised and did not bleed excessively but the wound became infected and he was given a course of antibiotics which controlled the infection.
When he was 6 weeks old he was noticed to be very pale and some bleeding occurred from the nose and he developed diarrhoea and was “grizzly”. Shortly thereafter he had difficulty in breathing and was taken to the nearest hospital.
Investigations in hospital
1. CT scan showed a Right Sided Subdural Haemorrhage. No retinal haemorrhages were seen
2. Skeletal X-Ray showed Periosteal reaction along the distal half of the right femur and a healing corner metaphyseal fracture of the distal right femur.
3. Ophthalmoscopy showed
a. Right retina clear
b. Left retina ”Boat shaped” haemorrhages involving all layers.
4. Blood Tests
1. Haemoglobin 63 gm/L NR 95 – 100
2. Platelets 706 x 109/L 160 – 600
3. Monocytes 1.3 x 109/L 0.2 – 1.2
Blood smear shows
a. Fragmented cells
b. Spherocytes
c. Anisocytosis
d. Abnormal monocytes
5. CRP 13.9mg/L NR < 6.0
6.Plasma Glucose 6.1 mmol/L 3.0 – 5.5
The child failed to respond to treatment and died shortly after admission.
Official Diagnosis – Non-accidental Injury.
Case Report 2.
Birth and Early History.
Birth was by normal delivery after a gestation period of 9 months. Apgar scores were 9/5 and 9/10 and screening for T4, PKU AND Galactosemia were all normal. He was given an IM injection of Vitamin K and Hepatitis B Vaccine was given 2 days later. He was breast fed.
Mother noticed this child was different from her two previous children in that “his body and head were never quite in proportion” in that his head was disproportionately large. He was vaccinated with DPaT, HiB, Polio vaccine.
At the age of 10 weeks he suddenly became lethargic, began twitching and passed urine which was tinged with blood and was immediately admitted to hospital.
Investigations
Blood Count
a. Haemoglobin 7.9b/dL NR 9.4 – 13
b. WBC“ 4.57 x10^3/UL 5.0 – 19.5
c. Platelets 741 x 10^3/UL 150 – 450
Blood Chemistry
a. pH 6.78 7.35 – 7.45
b. HCO3 7.2 mmol/L 22 – 28
c. Glucose 398 mg/d/L 70 – 105
d. Calcium 8.4 mg/dL 8.5 – 10.5
Liver Function Tests
a. AST 399 U/L 20 – 60
b. ALT 138 U/L 6 – 50
c. GGT 93 U/L 11 – 82
d. ALK PHOS 202 U/L 110 – 320
Coagulation Screen
a. Prothrombin Time 18.3 sec 11.5 – 14.5
b. INR 1.6 0.9 – 1.2
c. PTT 33.7 sec 24.0 – 35.0
X-Ray Chest
Healing posterior rib fractures of the right 10th and 11th ribs.
Healing fractures of anterior aspects of the right 6th and 7th ribs.
CT Brain without contrast.
Extensive subdural of mixed density overlying the right greater than the left cerebral hemispheres.
The Diagnosis was Non-accidental Injury and death occurred shortly after admission.
Autopsy confirmed the clinical findings and was reported as a Non-accidental Death.
Case Report 3.
A 2.9kg female infant was born by normal vaginal delivery after a gestation period of 9 months and mother and daughter returned home within 8 hours of the child’s birth. Mother noticed a bruise on the child’s leg but thought it was accidently bumped by a sibling.
At the age of 8 weeks the child was immunized with DPaT, HiB, Polio and Meningitis vaccine. Within 24 hours of having these vaccines the infant started vomiting intermittently and developed diarrhoea and was admitted to hospital.
Appropriate therapy was administered and the infant was fit to return home after a stay of 3 days in hospital.
While at home and being fed by the father she suddenly collapsed, stopped breathing and went limp. An ambulance was called and the child was returned to hospital.
Clinical Examination
The infant was unconscious and numerous bruises were noted on the face and trunk. She was intubated and further investigations were carried out.
Investigations
Skeletal X-Ray examination was performed which revealed multiple fractured ribs on both sides of the body
Blood Biochemistry
1. Urea 3.8 mmol/L 2.5 – 7,5
2. Creatinine 32 umol/L 0 – 61 3. Sodium 142 mmol/L 135 – 146
4. Potassium 3.3 mmol/L 3.5 – 5.5
5. Calcium 2.32 mmol/L 2.37 – 2.74
6. Albumin 28 g/L 35 – 55
7. Alkaline Phosphatase 321 U/L 65 – 265
8. Alanine Transaminase 59 U/L 5 – 45
Urine
1. Protein Trace
2. Glucose + by Multistix
The child died shortly after admission and an Autopsy was performed and the cause of death was reported as HEAD INJURY.
The father was arrested and charged with Murder.
Discussion
In case 1 the blood test showing markedly reduced Haemoglobin with an increase in monocytes, spherocytes, fragmented cells and anisocytosis when associated with an increase in CRP is highly suggestive of a Congenital Mononucleosis, a viral infection, causing an autoimmune haemolytic anaemia.
Laboratory investigations to demonstrate Liver dysfunction shown by an abnormal Alanine Transaminase levels and the presence of Glucose in the urine confirms hyperglycaemia was a feature of the infant’s illness.
In case 2 the child has clear evidence of both defective liver function as shown by the abnormal Liver Function Tests and hypoinsulinism as demonstrated by the increased level of Glucose in the blood.
In case 3 an abnormal Alanine Transaminase is evidence of a defective Liver function and the presence of Glucose in the Urine establishes hypoinsulinemia.
Conclusion.
In all three cases there is clear evidence that a metabolic disorder brought on by an autoimmune response to an antigen, including vaccines, caused hypoinsulinism which led to Tissue Scurvy. Tissue Scurvy could explain the neurological lesions reported in the literature.
A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it. T.S. Kuhn, The Structure of Scientific Revolutions).
‘All truth passes through three stages. First, it is ridiculed, second it is violently opposed, and third, it is accepted as self-evident.’ – Arthur Schopenhauer
The late Dr Mark Struthers reminds us that infantile scurvy, brought to our attention by Dr Archie Kalokerinos , is a potential cause of false allegations of child abuse.
Acknowledgements: I wish to thank the parents of the children reported here for providing me with the evidence needed to prepare the respective reports and I wish to thank my wife for helpful insights.
References
1.Turnbull HM. Encephalo-myelitis In Viral Diseases And Exantemata. Br Med J.1928 August 25,2(3529):331-334
2. A J Wakefield, S H Murch, A Anthony, J Linnell, D M Casson, et al;RETRACTED: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children Lancet Vol 351, Number 9103 28 February 1998
3. Kwok T, Cheng G, Lai WK, Poon P, Woo J, Pang CP. Use of fasting urinary methylmalonic acid to screen for metabolic vitamin B12 deficiency in older persons.Nutrition. 2004 Sep;20(9):764-8.
4. Innis MD. Autoimmunity and non-Accidental Injury in Children Clinical Medicine Research. MM-DD-2013, pp. x-x. doi:10.11648/j.
5. Buttram H E. Shaken Baby Syndrome or Vaccine Induced Encephalitis Medical Sentinel;2001:6(3),83-89
6. Innis MD Autoimmunity and non-Accidental Injury in Children Clinical Medicine Research. MM-DD-2013, pp. x-x. doi:10.11648/j.
7. Yazbak FE Testimony of Michael Belkin before the Advisory Committee on Immunization Practices – Centers for Disease Control and Prevention February 17,1999 _Atlanta Georgia
8. Herroelen L, de Keyser J, Ebinger G. Central-nervous-system demyelination after immunisation with recombinant hepatitis B vaccine. Lancet 1991;338:1174-1175. Lancet. 1991 Nov 338(8776):1174-5.
9.Kalokerinos A. Every Second Child. 1981 pp 3-165 Thomas Nelson (Australia)
10. Cunningham JJ. The Glucose/Insulin System and Vitamin C:Implications in Insulin-dependent Diabetes Mellitus. J Am Coll Nutr; 1998:vol 17 p105-108
11.Cunningham JJ, Ellis SL, McVeigh KL, Levine RE, ,Jorge Calies Escandon Reduced mononuclear leucocyte ascorbic acid content in adults with insulin-dependent diabetes mellitus consuming adequate dietary vitamin C Metabolism 1981;vol 40;148-149.
12. Innis MD. “Vitamin K Deficiency Disease”. Jour of Orthomol Med 2008;vol 23; 15-20
13. Innis MD. We should harness the power of our colleagues’ fresh ideas. BMJ Rapid Responses 24th July 2013.
14. Squier W. Beyond reasonable doubt Guardian March 13 2008.
15. Christian CW, Block R, and the Committee on Child Abuse and Neglect Abusive Head Trauma in Infants