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California and Western Medicine Mar 1944
PubMed: 18746712
DOI: No ID Found -
Proceedings of the Royal Society of... Dec 1932
PubMed: 19989039
DOI: No ID Found -
BMJ (Clinical Research Ed.) Oct 1990
Topics: History, 18th Century; History, 19th Century; History, 20th Century; History, Modern 1601-; Humans; Medicine in the Arts; Research; Scurvy; Smallpox Vaccine; United Kingdom
PubMed: 2224257
DOI: 10.1136/bmj.301.6754.763 -
The Journal of Nutrition Dec 2011We translated two Latin texts about scurvy. One is by Ambrosius Rhodius, who in 1635 published his doctoral thesis on scurvy. This contains aspects of 16th- and...
We translated two Latin texts about scurvy. One is by Ambrosius Rhodius, who in 1635 published his doctoral thesis on scurvy. This contains aspects of 16th- and 17th-century folklore medicine. The other is a 1593 letter by Henrik Høyer (Hoierus), a German physician in Bergen, Norway. The letter states that in Norway grew a plant, Chamaemorus Norvegicus, whose berries had curative abilities against scurvy. Rhodius lists symptoms of scurvy and suggests ingestion of fatty and smoked foods as etiological agents. He thought that a malfunction of the spleen was involved in this disease, so that the undigested parts of the chylus perturbed liver function. Plants with curative abilities were "those that abound in volatile salts." He listed seven facilitating causes of scurvy and its therapies. These included blood-letting after laxatives and root extracts. The star of the show was the cloudberry, which had miraculous effects on scurvy patients. Palliative care included a bath containing decoction of brooklime, water cress, mallow, hogweed, roman chamomile, and similar plants. Before bathing, the person was to drink an extract of wormwood, scurvy grass, or elder. As medication for gums and teeth, Rhodius recommended rosemary, hyssop, bistort, sage, nasturtium, waterweed, creeping Jenny, and scurvy grass. He referred to medications described by Albertus, Sennertus, and in antiquity by Hippocrates and Galenus. We discuss the manuscripts by Høyer and Rhodius in light of earlier treatments and opinions about scurvy.
Topics: Books; Fruit; History, 16th Century; History, 17th Century; Humans; Norway; Scurvy
PubMed: 22013203
DOI: 10.3945/jn.111.145334 -
Journal of Eating Disorders Mar 2023Although medical literature describes pediatric scurvy as "rare", a growing number of case reports suggests otherwise. Patients often undergo costly and unnecessary...
BACKGROUND
Although medical literature describes pediatric scurvy as "rare", a growing number of case reports suggests otherwise. Patients often undergo costly and unnecessary workup due to unfamiliarity with the presentation of scurvy. This case report further supports the small yet growing literature documenting scurvy and its manifestations in patients with eating disorders.
CASE PRESENTATION
A 15-year-old female presented to the emergency department with bilateral knee and ankle swelling and pain in the setting of chronic lower limb rash and BMI of 16.3. For years, she had restricted her diet to carbohydrates. Exam showed perifollicular petechial hemorrhagic rash with corkscrew hairs, knee edema, ankle edema with restricted range of motion, and antalgic gait. She was admitted for severe malnutrition from avoidant restrictive food intake disorder. Her hospital course was complicated by recurrent normocytic anemia and fever. Hematology workup revealed anemia from iron deficiency, vitamin K deficiency, and anemia of chronic disease. Rheumatology workup was negative. MRI findings showed dark T1 and bright T2 signals and were read as consistent with leukemia/lymphoma, chronic multifocal osteomyelitis, or Langerhans cell histiocytosis. However, bone marrow biopsy showed gelatinous transformation secondary to malnutrition. She was treated with vitamin C and a nutrition plan and her symptoms improved.
CONCLUSIONS
Although this patient had common manifestations of scurvy, including perifollicular petechial hemorrhagic rash, joint effusions, anemia, and recurrent fevers, she still underwent an extensive workup. Clinicians should be aware that scurvy can present with multiple symptoms that mimic infectious, rheumatic, oncologic and hematological disease. Clinicians should have a high index of suspicion for scurvy in patients with malnutrition and eating disorders.
PubMed: 36941672
DOI: 10.1186/s40337-023-00770-7 -
Cureus Apr 2023Scurvy is a multisystem disease caused by vitamin C deficiency, historically associated with lethargy, gingivitis, ecchymosis, edema, and death if left untreated....
Scurvy is a multisystem disease caused by vitamin C deficiency, historically associated with lethargy, gingivitis, ecchymosis, edema, and death if left untreated. Contemporary socioeconomic risk factors for scurvy include smoking, alcohol abuse, fad diets, mental health conditions, social isolation, and economic marginalization. Food insecurity is also a risk factor. This report describes a case of a man in his 70s who presented with unexplained dyspnea, abdominal pain, and abdominal ecchymosis. His plasma vitamin C level was undetectable, and he improved with vitamin C supplementation. This case highlights the significance of awareness of these risk factors and emphasizes the need for a comprehensive social and dietary history to enable the timely treatment of this rare but potentially fatal disease.
PubMed: 37252579
DOI: 10.7759/cureus.38091 -
Cleveland Clinic Journal of Medicine Jul 2020
Topics: Citrus; History, 18th Century; Humans; Male; Naval Medicine; Scurvy; Ships
PubMed: 32737036
DOI: 10.3949/ccjm.87b.08020 -
Proceedings (Baylor University. Medical... Apr 2018Vitamin C deficiency may be common in third-world countries due to malnutrition, but it is currently rare in the USA. Initially, nonspecific symptoms like exhaustion and...
Vitamin C deficiency may be common in third-world countries due to malnutrition, but it is currently rare in the USA. Initially, nonspecific symptoms like exhaustion and depression may make this disease difficult to diagnose until classical dermatological manifestations appear. Diagnosis mainly relies on clinical presentation, dietary history to identify risk factors, and dramatic recession of symptoms and signs following vitamin C therapy. Human beings cannot synthesize vitamin C and hence need 90% of vitamin C intake from fruits and vegetables. As a processed carbohydrate-rich diet becomes the staple food, scurvy must be recognized before it becomes potentially fatal. We describe a 65-year-old man with dyspnea, fatigue, anemia, and bleeding diathesis from scurvy and emphasize the importance of dietary history and the critical role of vitamin C in diagnosis and management of this forgotten entity.
PubMed: 29706829
DOI: 10.1080/08998280.2018.1435115 -
Pediatric Rheumatology Online Journal May 2024Vitamin C deficiency, or scurvy, is rare but poses risks for children with poor diets, limited resources, or malabsorption issues. It may also be common in children with...
BACKGROUND
Vitamin C deficiency, or scurvy, is rare but poses risks for children with poor diets, limited resources, or malabsorption issues. It may also be common in children with restrictive or selective dietary habits in children with global developmental delay, autism spectrum disorder, and physical disabilities. Symptoms include fatigue, irritability, joint and muscle pain, joint swellings, edema, swollen gums, easy bruising, and delayed wound healing. Early recognition and prompt intervention are essential to prevent the progression of symptomatic vitamin C deficiency in children.
CASE PRESENTATION
We present a case of a 13-year-old boy with developmental delay secondary to Lennox Gastaut syndrome referred for suspected recurrent, severe, and atypical IgA vasculitis. He presented with irritability, loss of appetite, petechial and ecchymotic lower limb lesions, unilateral gum swelling, severe arthritis, peripheral oedema, severe weight loss, anaemia, and raised inflammatory markers. Multiple investigations were performed before the diagnosis of scurvy was made. A surgical finding of friable gingival tissue with multiple loose teeth, a skin biopsy with follicular hyperkeratosis and extravasated perifollicular red blood cells, and a typical X-ray finding led to the diagnosis of scurvy.
CONCLUSION
Scurvy should be given careful consideration as a differential diagnosis in patients presenting with musculoskeletal issues, mucocutaneous complaints, and constitutional symptoms such as malaise, asthenia, irritability, and loss of appetite. A focused and detailed dietary history looking for a lack of good sources of vitamin C can be an easy indicator of this differential. Imaging studies revealing the typical features can also help make the diagnosis. Pathology of the skin revealing pathognomonic features can add to the certainty of the diagnosis. In the absence of all else, the rapid response to treatment with an appropriate dose of vitamin C has a diagnostic and therapeutic role.
Topics: Humans; Scurvy; Male; Adolescent; Diagnosis, Differential; Ascorbic Acid; IgA Vasculitis
PubMed: 38760753
DOI: 10.1186/s12969-024-00992-2 -
Health Science Reports Oct 2023Scurvy is a rare nutritional deficiency disease which is less likely to be suspected and it mostly lead to delayed diagnosis. It can present with features which can...
Scurvy is a rare nutritional deficiency disease which is less likely to be suspected and it mostly lead to delayed diagnosis. It can present with features which can mislead clinicians to misdiagnose the condition as leukemia or aplastic anemia. This can subject patients to the wrong management which leads to poor outcome and increased preventable morbidity and mortality. Vitamin C deficiency is still prevalent among pediatric population even in the modern days and should no longer be considered as historical condition. Chromosomal fragility has been greatly accounted for the development of leukemia and aplastic anemia secondary to various triggers. The role of vitamin C toward DNA stability, prevention, and control of mutations have been documented. Vitamin C plays a vital role in hematopoiesis by controlling regulation and prevent dysfunction of hematopoietic stem cells. Scurvy deficiency has been a silent growing clinical problem which needs a high index of suspicion for a clinician to pick it. It should be considered as one among potential differential diagnosis of leukemia and aplastic anemia especially in the pediatric population. History of any dietary restriction should be obtained and addressed properly. Serum vitamin C should be among the essential laboratory workout in diagnosis of both leukemia and aplastic anemia. All patients suspected to have such conditions should be screened and supplemented for vitamin C deficiency irrespective of positive confirmatory test results of leukemia or aplastic anemia since the probability of co-occurrence is likely also. Moreover, studies should be conducted to explore the clinical link, if any, between vitamin C deficiency or insufficiency and development of leukemia and aplastic anemia among the pediatric population given its physiological and genomic role in hematopoiesis. Furthermore, the potential pharmacological therapeutic use of vitamin C in treatment of leukemia and aplastic anemia should be determined clinically.
PubMed: 37808934
DOI: 10.1002/hsr2.1611