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Scurvy

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-Alec Rezigh

❓What❓

  • A multisystem disease of collagen fragility, deranged vasoreactivity, & inflammation that results from deficiency of vitamin C

❓Epidemiology❓

⊖ Malabsorption

  • Diet poor in fruits & vegetables

⊕ Malabsorption

  • Distal ileum disease
  • Cystic fibrosis
  • Celiac disease
  • Bariatric surgery
  • Hemodialysis

Presentation

↓ Collagen Cross-Linking

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Hematologic 🔴

Musculoskeletal 🦴

Dental 😬

Dermatologic 🔍

Deranged Vasoreactivity

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  • Pulmonary hypertension (↓ nitric oxide)

  • Orthostatic hypotension (↓ catecholamines)
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Inflammation

  • ↑ ESR, ↑ CRP

❓Diagnosis❓

While You’re Waiting …

  • Visualization of corkscrew hairs ⊕ perifollicular hemorrhage

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Definitive

  • [Vitamin C] measurement < 0.2 mg/dL

❓Treatment❓

  • Supplement!

📚 References 📚

  • Scurvy: Rediscovering a Forgotten Disease

  • Rheumatic manifestations of scurvy: a report of three recent cases in a major urban center and a review

  • Scurvy Can Be Mistaken for Rheumatologic Disorders

  • Vitamin C Deficiency

  • A Fruitful Workup (NEJM CPS)

  • LibreTexts (Vitamin C)

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Contact

Dx.atypia@gmail.com