Scurvy

Scurvy is a disease caused by deficiency of vitamin C (ascorbic acid), an essential cofactor for collagen synthesis. Without enough vitamin C, connective tissues weaken, causing gum disease, poor wound healing, and mucosal bleeding.

Causes and risk factors: It results from chronically low intake of vitamin C–rich fruits and vegetables or conditions that impair absorption or increase requirements. At-risk groups include people with very restricted diets, the elderly, those with alcoholism or eating disorders, and individuals with certain malabsorption conditions or after surgery.

Symptoms: Early signs are fatigue and gum inflammation; as it progresses there may be easy bruising, swollen gums, loose teeth, corkscrew hairs, poor wound healing, and anemia. Severe cases can feature joint pain, bone tenderness, subperiosteal bleeding, and edema.

Diagnosis: Based on dietary history and clinical signs; plasma or leukocyte vitamin C levels can help but may be affected by illness. A swift response to vitamin C supplementation also supports the diagnosis.

Treatment and prevention: Vitamin C is given orally or by injection; symptoms improve within days. Diets should include citrus fruits, peppers, berries, and leafy greens. Adults typically require about 75–90 mg of vitamin C daily; higher amounts are used to treat deficiency.

Prognosis and epidemiology: With treatment, recovery usually occurs within weeks. Untreated scurvy can be fatal. Historically common among sailors, scurvy is now rare in developed countries but can occur in settings of severe malnutrition.