Scurvy: Cause, Signs, Symptoms, and Treatment
8% of men and 6% of women in United States have vitamin C deficiency, also known as scurvy. Vitamin C deficiency shows slight male preponderance. Scurvy is common in infants who are not breastfed since adequate amount of ascorbic acid is present in breastmilk. Adults > 60 years of age can also develop scurvy secondary to chronic malnutrition. Risk factors of vitamin C deficiency include elderly males who live alone, alcoholism, smoking, and malabsorptive conditions such as inflammatory bowel disease and Whipple’s disease. Due to non-functional L-gluconolactone oxidase enzyme, humans are unable to synthesize L-ascorbic acid; it is an essential component for synthesis and repair of chondroitin sulphate and collagen. Since collagen is an important constituent of bone, lack of vitamin C can cause altered bone formation. Patient with scurvy usually complains of malaise, fatigue, bone pain, myalgia, and bleeding gums. The signs and symptoms of iron deficiency may also be present. Physical examination usually demonstrates ecchymosis and petechiae, swelling over long bones secondary to hemorrhage, and joint effusion. In pediatric age group, scorbutic rosary, also known as costochondral separation, may be demonstrated. it is an angle step-off deformity of costochondral junction. The diagnosis of scurvy is based on detailed history, physical examination, and relief of symptoms after vitamin C administration. Lab parameters are usually not helpful in diagnosis. The treatment of scurvy is vitamin C replacement. Vitamin C is administered orally. The adult dose is 250 mg four times a day for one week. Reference: https://www.orthobullets.com/basic-science/9034/scurvy
