Scurvy

Scurvy is a disease resulting from a deficiency of vitamin C (ascorbic acid). Vitamin C is essential for the synthesis of collagen, a protein crucial for the structure of various tissues in the body, including skin, blood vessels, tendons, ligaments, and bone.

Causes:

The primary cause of scurvy is insufficient dietary intake of vitamin C. Humans, unlike most animals, are unable to synthesize vitamin C internally and must obtain it from food sources. Common sources of vitamin C include citrus fruits (oranges, lemons, limes), berries, tomatoes, peppers, and leafy green vegetables. A diet lacking these sources over a prolonged period (typically 4-12 weeks) can lead to the development of scurvy. Factors contributing to insufficient intake include:

• Limited Access to Fresh Produce: Poverty, famine, or geographical isolation can restrict access to vitamin C-rich foods.
• Restricted Diets: Fad diets, restrictive eating disorders, and certain medical conditions requiring dietary limitations can inadvertently exclude sufficient vitamin C intake.
• Infant Feeding Practices: Infants fed exclusively on pasteurized milk (which contains reduced vitamin C) without vitamin C supplementation are at risk.
• Malabsorption: Certain medical conditions, such as severe gastrointestinal disorders, can impair the absorption of vitamin C from food.
• Alcoholism: Alcoholism is often associated with poor dietary habits and impaired vitamin C absorption.

Symptoms:

The symptoms of scurvy develop gradually and can range from mild to severe. Initial symptoms may include:

• Fatigue and Weakness: General feelings of tiredness and lack of energy.
• Irritability: Increased irritability and mood changes.
• Joint and Muscle Pain: Aches and pains in the joints and muscles.

As the deficiency progresses, more characteristic symptoms appear:

• Bleeding Gums: Gums become swollen, spongy, and bleed easily, particularly around the teeth.
• Loose Teeth: Teeth may loosen and eventually fall out due to weakened periodontal ligaments.
• Skin Changes: Small, pinpoint hemorrhages (petechiae) appear on the skin, often around hair follicles. The skin may also become rough and dry.
• Poor Wound Healing: Wounds heal slowly and may reopen.
• Corkscrew Hairs: Hairs become brittle and coiled, resembling corkscrews.
• Anemia: Reduced red blood cell count can lead to fatigue and shortness of breath.
• Swollen Joints: Bleeding into the joints can cause swelling and pain.
• Depression: Mental health can be affected, leading to depression.

In severe cases, scurvy can be fatal due to complications such as internal bleeding, infection, and cardiac arrest.

Diagnosis:

Diagnosis of scurvy is typically based on a combination of factors, including:

• Clinical History: A detailed history of dietary intake and symptoms.
• Physical Examination: Assessment of physical signs and symptoms suggestive of scurvy.
• Blood Tests: Measurement of vitamin C levels in the blood (plasma ascorbic acid). While helpful, low plasma levels do not always definitively confirm scurvy.
• Response to Treatment: Improvement in symptoms after vitamin C supplementation can confirm the diagnosis.
• Radiographic Imaging: In children, X-rays can reveal characteristic bone changes associated with scurvy.

Treatment:

The treatment for scurvy is straightforward and highly effective:

• Vitamin C Supplementation: Oral or intravenous administration of vitamin C. Dosage varies depending on the severity of the deficiency.
• Dietary Changes: Increasing the intake of vitamin C-rich foods in the diet.

Symptoms typically begin to improve within a few days of starting treatment, and complete recovery usually occurs within a few weeks.

Prevention:

Scurvy is easily preventable by ensuring adequate dietary intake of vitamin C. Recommended daily allowances of vitamin C vary depending on age, sex, and other factors. Consuming a balanced diet rich in fruits and vegetables is the best way to prevent vitamin C deficiency.