Pathology

Scurvy Symptoms and Treatment



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For the maintenance of good health, humans require a properly balanced diet. When deprived of certain vitamins humans may develop a number of conditions. The condition, scurvy, occurs in people with a dietary absence of Vitamin C (ascorbic acid). While most commonly seen in areas where the population relies on food aid owing to famine or war, occasional cases occur elsewhere. Most of these isolated cases occur through poverty or neglect in the elderly, alcoholics and sometimes anorexics.

Historically, scurvy occurred at sea during long sailing voyages with crews on restricted diets of salted meat and ship's biscuits. Land scurvy also occurred in specific groups in the past, notably amongst the combatants and prisoners in the American Civil War, those hopefuls in the Californian gold rush and members of some early expeditions to the Polar Regions.

Vitamin C plays an important part in the production of collagen and absorbing iron. Healthy production of collagen is important for healing wounds and maintaining bones, teeth and bodily tissues.

After a person's diet is deficient in Vitamin C for 1-3 months, the symptoms of the condition will start to appear. The timing of the start of symptoms depends on the amount of Vitamin C stored in the patient's body prior to the start of the deficient diet.

Early symptoms of scurvy include malaise (generally unwell), lethargy (tiredness), myalgia (muscle pain), and arthralgia (joint pain). These symptoms may be accompanied by tendency to bruise easily, anemia, bleeding into joints (with accompanying pain), bleeding around hair follicles, gum disease and loosened teeth as well as slow healing of any wounds.

Patients with advanced scurvy may exhibit jaundice, fluid retention, decreased urine production, nervous system damage fever (38°C, 110.4°F) and convulsions.

Young children with scurvy may exhibit, irritability, painful legs, anemia and hemorrhage (frequently into the ends of long bones).

A blood test will confirm a doctor's diagnosis of scurvy. Without treatment, scurvy is fatal, however, treatment is very effective. As well as advising on a change of diet to introduce foods rich in Vitamin C, the use of supplementary doses of Vitamin C helps. The usual dose at the start of treatment is 250 mg per day. When blood tests show a normal Vitamin C level this may be reduced to 40 mg per day to help maintain this level.

Following the start of treatment, any hemorrhaging normally ceases within 24 hours. Other symptoms of scurvy usually subside within a few weeks.

Babies may develop scurvy between 6-24 months of age if fed on a diet of heated milk (heating damages the Vitamin C found in fresh milk). Baby formulas usually contain added vitamins to prevent any deficiency. The use of fresh fruit or vegetable juices also helps prevent scurvy in heated milk fed infants

To prevent scurvy a diet including foods rich in Vitamin C is important. Such foods include fruits (lemons, oranges, limes, kiwi fruits etc.) and vegetables (broccoli, asparagus, cabbage, green peppers, sweet potatoes etc). Other foods rich in this vitamin include fish, fresh milk and liver. The recommended five portions of fruit and vegetables a day will contain more than enough vitamin C to prevent this disease.

Reference Sources:

NHS UK

eMedicine Medscape

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ARTICLE SOURCES AND CITATIONS
  • InfoBoxCallToAction ActionArrowhttp://www.nhs.uk/Conditions/Scurvy/Pages/Symptoms.aspx
  • InfoBoxCallToAction ActionArrowhttp://emedicine.medscape.com/article/985573-overview