Whats scurvy
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Understanding Scurvy: Causes, Symptoms, and Diagnosis
What is Scurvy?
Scurvy is a clinical condition caused by a deficiency of vitamin C (ascorbic acid). This essential nutrient plays a crucial role in collagen synthesis, iron absorption, and has antioxidant properties. Humans cannot synthesize vitamin C, so it must be obtained through dietary sources, primarily fruits and vegetables1 3 7.
Causes of Scurvy
Scurvy occurs due to prolonged insufficient intake of vitamin C, typically over a period of 1 to 3 months. It is most commonly seen in populations with poor dietary habits, including those with mental or physical disabilities, alcoholics, the elderly, and individuals with restrictive diets1 3 4 7. Children with autism spectrum disorder (ASD) and severe food selectivity are also at risk2.
Clinical Features and Symptoms
Scurvy presents with a wide range of symptoms due to its impact on multiple organ systems. Common manifestations include:
- Musculoskeletal Complaints: Myalgia, arthralgias, and musculoskeletal pain are frequent symptoms1 4.
- Mucocutaneous Lesions: Gingival bleeding, perifollicular hemorrhage, petechiae, and ecchymoses are typical skin findings1 5 8.
- Systemic Symptoms: Fatigue, lethargy, and anemia are often reported1 3 7.
- Advanced Disease: In severe cases, bleeding from the gums, leg ulceration, and even sudden death can occur due to infection or hemorrhage3 9.
Differential Diagnosis
Scurvy can mimic several other conditions, including autoimmune diseases, infections, and neoplasia. Common misdiagnoses include vasculitis, blood dyscrasias, and ulcerative gingivitis1 3 9. In children, symptoms of scurvy can be mistaken for other pediatric conditions such as cancer, leading to extensive and costly diagnostic testing2.
Diagnosis
A focused dietary history and careful physical examination are crucial for diagnosing scurvy. The gold standard for diagnosis is the measurement of serum vitamin C levels. Imaging studies can also reveal typical features of scurvy, such as changes in the bones and soft tissues1 4. In children with ASD and severe food selectivity, a nutrition evaluation and laboratory testing are recommended before more elaborate testing2.
Conclusion
Scurvy, though rare in modern developed countries, remains a significant health concern in at-risk populations. Early recognition and diagnosis are essential to prevent unnecessary investigations and potentially fatal complications. Vitamin C supplementation is an effective treatment, leading to rapid improvement in symptoms. Clinicians should consider scurvy in patients presenting with musculoskeletal complaints, mucocutaneous lesions, and systemic symptoms, especially those with poor dietary habits or underlying risk factors.
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Most relevant research papers on this topic
A Narrative Review on Pediatric Scurvy: The Last Twenty Years
Pediatric scurvy is increasingly reported in children, with a wide clinical spectrum and potential for misdiagnosis, requiring early diagnosis to avoid complications.
Systematic Review
Very Rigorous JournalScurvy as a Sequela of Avoidant-Restrictive Food Intake Disorder in Autism: A Systematic Review.
Scurvy is a potential risk in children with autism spectrum disorder and severe food selectivity, and diagnosis requires a nutrition evaluation and laboratory testing before more elaborate testing.
Systematic ReviewScurvy: historical review and current diagnostic approach.
Scurvy is a common deficiency of vitamin C, often found in disadvantaged groups, and can be effectively treated with vitamin C administration.
Highly CitedRevisiting the pathobiology of scurvy: a review of the literature in the context of a challenging case
Scurvy is a nutritional disorder caused by vitamin C deficiency, with atypical clinical and pathological findings in skin, blood, and bone marrow, and can be exacerbated by other comorbidities.
Scurvy: Rediscovering a Forgotten Disease
Scurvy, caused by low vitamin C levels, can be effectively treated and prevented through vitamin C supplementation, affecting multiple organ systems and being associated with alcoholism, low socio-economic status, and poor dietary habits.
A case report on modern-day scurvy
Scurvy, caused by a nutritional deficiency of Vitamin C, is a potential diagnosis in at-risk patients with symptoms like lethargy, gum disease, and easy bruising.
Case ReportScurvy in the Modern World: Extinct or Not?
Scurvy is a nutritional disorder caused by vitamin C deficiency, and it can still cause symptoms like petechial rash and easy bruising in the modern world, especially in at-risk populations.
Case Report
Rigorous JournalScurvy: a forgotten but still present disease
Scurvy is a common and severe multisystemic disease, often overlooked due to its association with grain and animal protein-based diets.
Case Report