scurvy

(skŭr′vē)

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A disease caused by a vitamin deficiency resulting from inadequate consumption of ascorbic acid (vitamin C) in the diet.
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SCURVY

INCIDENCE
In economically advanced nations, scurvy is present in about 6% or less of the population. In these nations it is most prevalent among alcoholics, the mentally ill, anorectics and food faddists, people with intestinal malabsorption syndromes, pregnant women, and the socially isolated older adults who subsist on limited nutritional choices. During famine, war, and agricultural crises in the developing world, it is far more common than it is in resource-rich nations.

CAUSES
The body's reservoir of vitamin C can be depleted in as little as 30 days. Human beings are unable to make their own vitamin C from its substrates, and the vitamin must be consumed whole. Vitamin C has many oxidative-reductive metabolic functions, e.g., the synthesis of collagen. Malformation of collagen lies at the root of many of the clinical manifestations of scurvy.

SYMPTOMS AND SIGNS
Symptoms include fatigue, bleeding from the skin, joints and gums; impaired wound healing; weakening of bones and impairment in bone growth; dry skin; edema in the lower extremities; follicular hyperkeratosis; anemia; and coiling of body hairs.

DIAGNOSIS
Scurvy can be diagnosed from its clinical presentation, followed by restoration of health when vitamin C supplementation is provided. Levels of vitamin C are sometimes used to confirm the diagnosis. Bone x-rays help diagnose infantile scurvy.

PREVENTION
Scurvy can be prevented with regular consumption of fruits and vegetables (or juices made from them), which provide an abundant supply of vitamin C in the diet.

TREATMENT
Scurvy can be treated by providing about 1 gm of ascorbic acid daily, for about a week, usually in divided doses at meal time.

IMPACT ON HEALTH
Full recovery from scurvy is likely once nutritional supplements are consumed. Patients usually improve within a few days to a few weeks. When scurvy is left untreated, however, it may prove fatal.

PATIENT CARE
Nutritional consultation is the cornerstone of patient care.

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