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Overview :
Scurvy is the term for clinical deficiency of vitamin C
(ascorbic acid). Although encountered less often today than in the past, it
still occurs and mild cases may go unrecognized.
Patients at risk for vitamin C deficiency:
(1) infants
(2) adults > 55 years of age, especially males
(3) refugees or displaced persons
(4) malnutrition
(5) heavy cigarette smokers
(6) abnormal diets devoid of vegetables and vitamins
Clinical features of scurvy - bleeding tendency:
(1) petechiae
(2) purpura
(3) ecchymoses
(4) subperiosteal hemorrhage
(5) bleeding gums
(6) intracranial hemorrhage, which may be fatal
(7) conjunctival hemorrhages
Clinical features of scurvy - oral:
(1) gingival swelling and gingivitis
(2) loose or missing teeth
(3) scurvy buds on the gingiva
Clinical features of scurvy - skeletal changes in
children:
(1) bowing of long bones in the lower extremities
(2) scorbutic rosary (depression of sternum with projection
of the ends of the ribs)
(3) tender or aching limbs
Clinical features of scurvy - other:
(1) anemia
(2) hyperkeratosis
(3) abnormal wound healing
(4) poor localization of bacterial infections
(5) fatigue or weakness
The diagnosis of scurvy involves both of the following:
(1) the
presence of clinical features in a person with a risk factor for vitamin C
deficiency
(2) low
blood levels of vitamin C, or clinical response to ascorbic acid replacement
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