{"id":4422614,"date":"2025-01-12T08:00:29","date_gmt":"2025-01-12T14:00:29","guid":{"rendered":"https:\/\/myendoconsult.com\/learn\/topics\/scurvy\/"},"modified":"2025-01-12T08:04:37","modified_gmt":"2025-01-12T14:04:37","slug":"scurvy","status":"publish","type":"oen_topic","link":"https:\/\/myendoconsult.com\/learn\/topics\/scurvy\/","title":{"rendered":"Scurvy"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">OVERVIEW oF SCURVY<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Vitamin C (ascorbic acid)<\/strong>:\n<ul class=\"wp-block-list\">\n<li>An <strong>essential<\/strong> water-soluble <a href=\"https:\/\/myendoconsult.com\/learn\/topics\/vitamins\/\"  data-wpil-monitor-id=\"300\">vitamin<\/a> (humans cannot synthesize it).<\/li>\n\n\n\n<li>Found in <strong>citrus fruits, tomatoes, potatoes, cabbage, spinach, Brussels sprouts, cauliflower, broccoli, strawberries<\/strong>.<\/li>\n\n\n\n<li>Scurvy may appear after <strong>~3 months<\/strong> of a vitamin C\u2013free diet.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">BIOCHEMICAL ROLE<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Ascorbic acid<\/strong> is the enolic form of \u03b1-ketolactone.<\/li>\n\n\n\n<li>Functions as a <strong>cofactor\/cosubstrate<\/strong> in reactions using iron or copper (provides reducing equivalents).<\/li>\n\n\n\n<li>Key enzymatic processes include:\n<ul class=\"wp-block-list\">\n<li><strong>Collagen synthesis<\/strong> (hydroxylation of proline &amp; lysine residues).<\/li>\n\n\n\n<li>Carnitine synthesis (cofactor).<\/li>\n\n\n\n<li>Conversion of dopamine to norepinephrine (dopamine \u03b2-hydroxylase).<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Absorption<\/strong>: Takes place in <strong>jejunum and ileum<\/strong>; blood levels are regulated by <strong>renal excretion<\/strong>.<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">SCURVY<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Definition &amp; History<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Nutritional deficiency disorder caused by <strong>lack of vitamin C<\/strong>.<\/li>\n\n\n\n<li>Known since antiquity; historically linked to <strong>prolonged sea voyages<\/strong> with no fresh food.<\/li>\n\n\n\n<li>Dr. James Lind (1754) linked intake of <strong>oranges\/lemons<\/strong> to preventing scurvy.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Clinical Features<\/h3>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>General Symptoms<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Onset is <strong>insidious<\/strong>.<\/li>\n\n\n\n<li>Weakness, malaise, shortness of breath.<\/li>\n\n\n\n<li>Bone pain, myalgias, arthralgias, edema, neuropathy.<\/li>\n\n\n\n<li>Vasomotor instability.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Skin &amp; Connective Tissue<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Impaired collagen \u2192 defective <strong>wound healing<\/strong>.<\/li>\n\n\n\n<li><strong>Hyperkeratotic papules<\/strong>, perifollicular hemorrhages, follicular hyperkeratosis (coiled\/frayed hair).<\/li>\n\n\n\n<li>Petechial hemorrhages (often start on lower extremities).<\/li>\n\n\n\n<li><strong>Rumpel-Leede sign<\/strong> (abnormal capillary fragility): inflating BP cuff causes many petechiae.<\/li>\n\n\n\n<li>Large ecchymoses or even proptosis from retrobulbar hemorrhage.<\/li>\n\n\n\n<li>Subungual \u201csplinter\u201d hemorrhages.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Joints &amp; Bones<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Hemorrhage into joints \u2192 pain, swelling, limited movement.<\/li>\n\n\n\n<li><strong>In infants<\/strong>: subperiosteal hemorrhages \u2192 \u201cfrog leg\u201d posture, \u201cpseudoparalysis\u201d from pain.<\/li>\n\n\n\n<li>Impaired osteoblast function \u2192 stunted growth in children.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Gingival Changes<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Gums become swollen, reddish-blue, spongy, friable.<\/li>\n\n\n\n<li>Loosening\/falling of teeth.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Severe Cases<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Possible <strong>massive cerebral hemorrhages<\/strong> with hyperpyrexia, tachycardia, cyanosis, hypotension, Cheyne-Stokes respirations, leading to death.<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">DIAGNOSIS<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Scurvy is seen in <strong>severely malnourished<\/strong> individuals (e.g., certain alcoholics).<\/li>\n\n\n\n<li><strong>Laboratory<\/strong>: Serum ascorbic acid level &lt;0.3 mg\/dL indicates severe deficiency (normal: 0.6\u20132.0 mg\/dL).<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">TREATMENT<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Ascorbic acid<\/strong> supplementation:\n<ul class=\"wp-block-list\">\n<li>Typically <strong>500 mg\/day<\/strong> until resolution of signs\/symptoms.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Address underlying causes of dietary deficiency or malabsorption.<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">PREVENTION<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Recommended daily allowance<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Men: 90 mg\/day<\/li>\n\n\n\n<li>Women: 75 mg\/day<\/li>\n\n\n\n<li>Pregnant\/Lactating women: ~120 mg\/day<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Achievable with <strong>balanced diets<\/strong> including <strong>citrus fruits and vegetables<\/strong>.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>OVERVIEW oF SCURVY BIOCHEMICAL ROLE SCURVY Definition &amp; History Clinical Features DIAGNOSIS TREATMENT PREVENTION<\/p>\n","protected":false},"featured_media":0,"template":"","oen_topic_chapter":[689],"class_list":["post-4422614","oen_topic","type-oen_topic","status-publish","hentry","oen_topic_chapter-obesity-medicine","post-wrapper","thrv_wrapper"],"_links":{"self":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/oen_topic\/4422614","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/oen_topic"}],"about":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/types\/oen_topic"}],"version-history":[{"count":3,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/oen_topic\/4422614\/revisions"}],"predecessor-version":[{"id":4422618,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/oen_topic\/4422614\/revisions\/4422618"}],"wp:attachment":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/media?parent=4422614"}],"wp:term":[{"taxonomy":"oen_topic_chapter","embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/oen_topic_chapter?post=4422614"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}