What causes scurvy
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Causes of Scurvy: A Comprehensive Overview
Vitamin C Deficiency as the Primary Cause
Scurvy is primarily caused by a deficiency of vitamin C, also known as ascorbic acid. This essential nutrient plays a crucial role in the synthesis of collagen, a protein necessary for the maintenance of healthy connective tissues, skin, blood vessels, and bones. Without adequate vitamin C, the body cannot properly form collagen, leading to the symptoms associated with scurvy 12456.
Dietary Habits and Risk Factors
Restricted and Peculiar Diets
Individuals who consume a restricted or peculiar diet for extended periods are at high risk of developing scurvy. For instance, a case study described a 31-year-old man who developed scurvy after adhering to a highly restricted diet for one year. His symptoms included perifollicular hemorrhages, follicular hyperkeratosis, corkscrew hairs, and gingival hemorrhage, all of which resolved after vitamin C supplementation .
Pediatric Scurvy and Dietary Habits
Children with abnormal dietary habits, mental or physical disabilities, or those with avoidant-restrictive food intake disorder (ARFID) are particularly susceptible to scurvy. Recent studies have shown an increase in scurvy cases among children with autism spectrum disorder (ASD) who exhibit severe food selectivity. These children often undergo extensive diagnostic testing before scurvy is identified, delaying appropriate treatment 249.
Socioeconomic and Lifestyle Factors
Scurvy is more commonly diagnosed in individuals with low socioeconomic status, the elderly, and those suffering from alcoholism. These groups often have poor dietary habits that lack sufficient vitamin C intake. For example, an elderly alcoholic woman developed scurvy, which was diagnosed based on her dietary history and dermatologic findings. Her symptoms resolved quickly with vitamin C supplementation 56.
Misdiagnosis and Clinical Presentation
Wide Clinical Spectrum
Scurvy can present with a wide range of symptoms, making it easy to misdiagnose. Common manifestations include gingival bleeding, arthralgias, skin discoloration, impaired wound healing, perifollicular hemorrhage, and ecchymoses. These symptoms can mimic other conditions such as autoimmune diseases, infections, and neoplasia, leading to diagnostic delays 258.
Diagnostic Challenges
The diagnosis of scurvy is often delayed due to its varied presentation and the presence of normal nutritional status, anemia, or elevated inflammatory markers in patients. A focused dietary history and physical examination are crucial for identifying signs of vitamin C deficiency. Serum vitamin C levels serve as the diagnostic gold standard, and imaging studies can reveal typical features of scurvy 249.
Historical and Bioarchaeological Evidence
Ancient and Modern Cases
Scurvy has been documented since ancient times and continues to be identified in modern populations. Bioarchaeological evidence from Southeast Asia and the Atacama Desert in Northern Chile has shown skeletal manifestations of scurvy, indicating its historical prevalence. These findings highlight the importance of dietary diversity and the impact of social and environmental factors on vitamin C levels 710.
Conclusion
Scurvy is a preventable and treatable disease caused by a deficiency of vitamin C. It is most commonly seen in individuals with restricted diets, low socioeconomic status, and certain medical conditions. Early diagnosis and treatment with vitamin C supplementation can resolve symptoms and prevent complications. Awareness of the varied clinical presentation and risk factors is essential for timely identification and management of this condition.
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