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Scurvy
Published in Charles Theisler, Adjuvant Medical Care, 2023
Inadequate production of collagen can lead to anemia (due to vascular fragility and subsequent subcutaneous hemorrhages), weakness, exhaustion, swelling and pain in the limbs (especially the legs), slow healing, perifollicular hyperkeratotic papules (reddish/bluish bruise-like spots surrounding hair follicles) on the shins, ulceration of the gums with loose and lost teeth, and possibly even death.1 In infants there can be malformation of bones and teeth. Modern cases of scurvy are relatively rare, but can still affect individuals who do not consume enough vitamin C.2
Nutritional and Dietary Supplementation during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Vitamin C (ascorbic acid) is an essential nutrient. Deficiency of vitamin C causes scurvy. No increase in the use of vitamin C was found in a case-control study of the use of vitamin C during the first trimester by mothers of 175 infants with major congenital anomalies and 283 with minor anomalies compared to the control group (Nelson and Forfar, 1971). Embryo-fetal effects of megadoses of vitamin C during pregnancy have not been published. Two infants born to women who took more than six times the RDA of vitamin C during pregnancy had scurvy (Cochrane, 1965).
Fruits
Published in Christopher Cumo, Ancestral Diets and Nutrition, 2020
As noted, many fruits have vitamin C. Chapter 2 discussed its prevention and treatment of scurvy, its antioxidant properties, and its role in helping the body absorb iron. Besides these functions, the body uses vitamin C to synthesize neurotransmitter norepinephrine. Ascorbic acid may improve memory and cognition.36 Although drying increases fruits’ storage, it reduces or eliminates the vitamin.37 Fruits may have additional nutrients, including potassium, carotenoids (vitamin A precursors), and vitamin B9, though—as with any food—macro- and micronutrients depend on many factors.
Just Right Challenge Feeding Protocol: Case-Report for Guiding Clinical Reasoning and Future Research in Food Selectivity Treatment
Published in Occupational Therapy In Health Care, 2022
The nutritional consequences of food selectivity can be severe. Children with food selectivity often restrict their diets to consumption of high fat, high sugar, and processed foods and refuse to eat whole foods including vegetables and fruits (Sharp et al., 2018). Malnutrition with deficits in vitamin D, fiber, vitamin E, calcium and others have been documented (Sharp et al., 2018; Hyman et al., 2012). Additionally, several studies have identified scurvy as a result of long standing refusal of fruits and vegetables without supplemental sources of Vitamin C (Ma et al., 2016; Swed-Tobia et al., 2019). These nutritional deficits point to clear and concerning health implications of food selectivity and a call for intervention to address dietary expansion for adequate diversity that includes vegetables and fruits (Chawner et al., 2019).
Scurvy in a patient with a restrictive diet
Published in Baylor University Medical Center Proceedings, 2021
Patrick W. Shin, Adrienne M. Gonzales, Christie M. Pham, Tapas Gajjar
Ascorbic acid is an essential nutrient required for collagen synthesis and repair. Though adequate levels of vitamin C can be obtained through consuming minimal fruits and vegetables, extremely restricted diets can lead to symptomatic scurvy within 2 months.3 Diagnosis is largely clinical, with recognition of corkscrew hairs, perifollicular hemorrhages, impaired wound healing, and bleeding diathesis. Diagnosis may be aided with serum vitamin C levels, vitamin C tolerance tests, and follicular biopsy.3 Once scurvy has been identified, treatment consists of 300 to 500 mg of vitamin C daily, and symptoms usually improve within 2 weeks.4 Supplementation should be continued if the diet remains restricted. If left untreated, scurvy can lead to hemarthrosis, spontaneous bleeding, hemorrhagic pericarditis, arrhythmias, and potentially death.3
Scurvy in 2017 in the USA
Published in Baylor University Medical Center Proceedings, 2018
Krishna M. Baradhi, Shobana Vallabhaneni, Supriya Koya
Scurvy, a disease caused by a deficiency of vitamin C, is uncommon in the modern era and is often underdiagnosed. Vitamin C serves as a cofactor in collagen synthesis, and its deficiency is characterized by hemorrhagic diathesis. We describe a case of scurvy presenting with anemia, perifollicular hemorrhages, and extensive ecchymoses and highlight the importance of recognizing vitamin C deficiency as a cause of bleeding diathesis.