Scurvy

Background

Scurvy is the nutritional deficiency of Vitamin C (Ascorbic acid). Vitamin C is typically foundin fruits and vegetables. Vitamin C is a cofactor for hydroxylation of proline and lysine amino acids in procollagen molecules, which is required for cross-linking collagen's triple helix. Scurvy therefore leads to unstable collagen and collagen fragility. This leads to the following:

• • leaking of vascular structures
    • gingival bleeding
    • petechiae
    • easy bruising

Vitamin C is also required for the disulfide bonding in hair. Deficiency will thus lead to the following:

• • Corkscrew appearance of hair.

Clinical Features

• Gingival bleeding
• Easy bruising
• Petechiae
• Corkscrew hair

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  Corkscrew hair in a patient with scurvy.

• 

  Petechiae in a patient with scurvy.

• 

  Bruising in a patient with scurvy.

• 

  Gingival bleeding in a patient with scurvy.

Diagnosis

Guided by clinical suspicion but confirmed with laboratory analysis of vitamin C levels.

Management

Vitamin C supplementation.

References

1. Kluesner, Nicholas and Miller, daniel. “Scurvy: Malnourishment in the land of the plenty.” The journal of emergency medicine. Vol 46. no 4. pages 530-532. 2014.
2. Maltos, andre, et al. “Scurvy in a patient with AIDS: case report.” Revista de sociedade brasileira de medicina tropical 44(1): 122-123. 2011.