Scurvy: historical review and current diagnostic approach

Pimentel, Laura

doi:10.1016/s0735-6757(03)00083-4

Cited by 107 publications

(108 citation statements)

References 13 publications

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“…As discussed above, scurvy is associated with low dietary diversity, and can be found in individuals experiencing general undernutrition (e.g., starvation) or those relying on a few, micronutrient poor staple foods for caloric sufficiency (Snoddy et al, 2017; World Health Organization, 1999). Clinically, individuals suffering from scurvy are also usually deficient in a number of other micronutrients, such as folate or iron, which will not necessarily leave diagnostic osseous markers (Pimentel, 2003; Popvich, McAlhany, Adewumi, & Barnes, 2009). The development and consistent application of a robust diagnostic protocol for the identification of scurvy from human skeletal remains is therefore of importance to those who study the wider context of nutritional stress in ancient human groups.…”

Section: Scurvy Dietary Diversity and Paleodietary Reconstructionmentioning

confidence: 99%

“…The RDA for children aged 1–3 years is 15 mg, with incremental increases until reproductive maturity is reached (NIH, 2018). The absolute minimum daily intake necessary to prevent scurvy is thought to be 10 mg in adults (Hirschmann & Raugi, 1999: 899; Levine et al, 1999; Pimentel, 2003, p. 331; Popvich et al, 2009). If this minimum requirement is unmet long enough for somatic stores to fall below 350 mg (~1–3 months), scurvy can occur and if left untreated it is invariably fatal (Fain, 2005; NIH, 2018).…”

Section: Vitamin C In Human Healthmentioning

confidence: 99%

“…Scurvy is associated with a number of nonspecific symptoms, such as fatigue, irritability, and depression (Olmedo, Yiannias, Windgassen, & Gornet, 2006; Pimentel, 2003; Popvich et al, 2009). However, the majority of clinical signs are directly related to defective type II collagen synthesis.…”

Section: Clinical Manifestations Of Deficiencymentioning

confidence: 99%

“…Musculoskeletal lesions occur in the majority of clinical cases of subadult scurvy and radiography of suspected scorbutic individuals is standard practice in differential diagnosis (Pimentel, 2003; Riepe, Eichmann, Oppermann, Schmitt, & Tunnessen, 2001; Verma et al, 2007; Young et al, 1979). The majority of radiographically visualized diagnostic lesions are metaphyseal and associated with defective endochrondral growth.…”

Section: Clinical Manifestations Of Deficiencymentioning

confidence: 99%

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Macroscopic features of scurvy in human skeletal remains: A literature synthesis and diagnostic guide

Snoddy

Buckley

Elliott

et al. 2018

American J Phys Anthropol

101

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The past two decades have seen a proliferation in bioarchaeological literature on the identification of scurvy, a disease caused by chronic vitamin C deficiency, in ancient human remains. This condition is one of the few nutritional deficiencies that can result in diagnostic osseous lesions. Scurvy is associated with low dietary diversity and its identification in human skeletal remains can provide important contextual information on subsistence strategy, resource allocation, and human‐environmental interactions in past populations. A large and robust methodological body of work on the paleopathology of scurvy exists. However, the diagnostic criteria for this disease employed by bioarchaeologists have not always been uniform. Here we draw from previous research on the skeletal manifestations of scurvy in adult and juvenile human skeletal remains and propose a weighted diagnostic system for its identification that takes into account the pathophysiology of the disease, soft tissue anatomy, and clinical research. Using a sample of individuals from the prehistoric Atacama Desert in Northern Chile, we also provide a practical example of how diagnostic value might be assigned to skeletal lesions of the disease that have not been previously described in the literature.

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Section: Scurvy Dietary Diversity and Paleodietary Reconstructionmentioning

confidence: 99%

Section: Vitamin C In Human Healthmentioning

confidence: 99%

Section: Clinical Manifestations Of Deficiencymentioning

confidence: 99%

Section: Clinical Manifestations Of Deficiencymentioning

confidence: 99%

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Macroscopic features of scurvy in human skeletal remains: A literature synthesis and diagnostic guide

Snoddy

Buckley

Elliott

et al. 2018

American J Phys Anthropol

101

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“…As often reported, the diagnosis may be misled as the presenting symptoms mimic diseases more commonly seen in developed countries [8]. In the present case, other diagnoses were first considered, including a psychiatric disorder, myositis and a blood malignancy.…”

Section: Discussionmentioning

confidence: 72%

Scurvy hidden behind neuropsychiatric symptoms

et al. 2011

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Approaching an uncommon disease may result in diagnostic delay even in patients with typical clinical features. In this respect, diseases related to nutritional deficiencies may represent a diagnostic challenge. We describe a 2.5-year-old child with typical features of scurvy, who was referred for autistic-like behavior and severe muscle weakness and pain in lower limbs. Extensive investigations for non-nutrition-related disorders were first performed, including a muscle biopsy showing a selective type II fibers hypotrophy. Scurvy was eventually considered, after recalling the child's peculiar dietary habits.

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A Patient With Psychiatric Illness and Multiple Hemorrhages

Baalen

Trajkovic

Boiten

2019

JAMA

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A 61-year-old man with a history of hypertension, psychosis, and recurrent venous thromboembolism had fatigue, weakness, and arthralgias after an unexplained fall, as well as peripheral edema of the lower extremities with widespread hematomas, ecchymosis, and perifollicular hemorrhage and petechiae. Laboratory testing revealed normocytic anemia, low folic acid level, and normal coagulation values. What is the diagnosis and what would you do next?

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Scurvy: historical review and current diagnostic approach

Cited by 107 publications

References 13 publications

Macroscopic features of scurvy in human skeletal remains: A literature synthesis and diagnostic guide

Macroscopic features of scurvy in human skeletal remains: A literature synthesis and diagnostic guide

Scurvy hidden behind neuropsychiatric symptoms

A Patient With Psychiatric Illness and Multiple Hemorrhages

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