Adult scurvy

Hirschmann, Jan V.; Raugi, Gregory J.

doi:10.1016/s0190-9622(99)70244-6

Cited by 255 publications

(369 citation statements)

References 44 publications

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“…Many characteristic symptoms and signs of severe vitamin C deficiency, upon which the diagnosis of scurvy is established, 1 were present in our patient: general symptoms (fatigue and lethargy), oral findings (spontaneous bleeding, gum retraction and loss of dentition), cutaneous abnormalities (including hemorrhagic skin lesions predominantly in the lower limbs) and musculoskeletal findings (severe pain upon mobilization). In addition, plasma vitamin C levels were well below o11.4 mmol/l, a lower value associated in the literature with significant vitamin C depletion.…”

Section: Discussionmentioning

confidence: 57%

Severe vitamin C deficiency in a critically ill adult: a case report

Doll

Ricou

2013

Eur J Clin Nutr

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Scurvy, a severe form of vitamin C deficiency, killed scores of people until its cause and treatment were firmly established at the end of the eighteenth century. Since then, cases have surged periodically around the world, mostly in developing countries and during times of war and famine. In developed countries, scurvy is still endemic and evidence is growing that vitamin C deficiency might affect up to 30 percent of the population. Low socio-economic status, alcoholism, severe psychiatric illness leading to poor nutrition and critical illness are significant risk factors. We hereby report the case of a patient admitted in a Swiss intensive care unit of a tertiary teaching hospital and presenting with clinical signs and symptoms of severe vitamin C deficiency.

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Section: Discussionmentioning

confidence: 57%

Severe vitamin C deficiency in a critically ill adult: a case report

Doll

Ricou

2013

Eur J Clin Nutr

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“…Smokers metabolize two times more ascorbic acid compared to nonsmokers. [4] Without fortified foods or vitamins, 45% of people will consume less than the average estimated requirement of ascorbic acid. [5] With recent health trends in the United States, this may place a large portion of the population at risk.…”

Section: Introductionmentioning

confidence: 99%

Vitamin C or not to see: A diagnostic dilemma

Zemore

Warner

2015

CRIM

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Scurvy is a severe deficiency of vitamin C, or ascorbic acid. Despite it's perceived rarity in developed countries, certain populations are at higher risk of developing scurvy, and a delay in diagnosis can lead to significant morbidity and possibly death. In this case, a 46-year-old female was admitted to the hospital with subtle mood changes, memory loss, and generalized failure to thrive. Physical exam revealed a petechial rash. Evaluation and workup by multiple physicians revealed no source for her condition, which continued to deteriorate. Finally, because of the patient's rash, a nutritional history was taken which was highly concerning for scurvy. An ascorbic acid level was ordered and returned at 0 mg/dl (reference range 0.2-2 mg/dl), confirming the clinical diagnosis of scurvy. Ascorbic acid repletion reversed her symptoms and she was discharged home uneventfully. Ascorbic acid is vital for the integrity of skin and soft tissues. Due to its high prevalence in the diets of most developed countries, scurvy has become a rare diagnosis that many providers do not recognize. Despite its rarity, certain populations are still at risk and providers should remain cognizant of the diagnosis, especially when classic manifestations such as a petechial rash or bleeding gums are seen.

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“…Other clinical findings may include fatigue, keratitis, psychosis and pericardial effusion. 1 The differential diagnosis includes vasculitides, such as Wegener granulomatosis, ChurgStrauss syndrome and microscopic polyangiitis. The characteristic finding of corkscrew hair may be mistaken for Menkes syndrome.…”

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confidence: 99%

“…3 It enhances the absorption of dietary iron and plays a key role in the development and stability of collagen. 1 Hence, vitamin C deficiency results in fragility in collagen structures, such as blood vessel walls.…”

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confidence: 99%

“…Given the increased availability of fresh fruits and vegetables in developed countries, most reported instances are found in marginalized populations, including people with substance abuse, cognitive impairment or mental illness. 1 Those with reduced dietary intake or malabsorption syndromes from surgery or disease may also be affected. It is important to note that children of parents who follow restrictive dietary fads may be at increased risk.…”

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confidence: 99%

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