Rheumatic Manifestations of Scurvy

Ferrari, Claudia; Possemato, Niccolò; Pipitone, Nicolò; Manger, Bernhard; Salvarani, Carlo

doi:10.1007/s11926-015-0503-6

Cited by 16 publications

(18 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cutaneous manifestations, such as petechiae, ecchymoses, and hyperkeratosis can develop later, after about five months of a vitamin C-deficient diet. Occasionally, the purpura becomes palpable and the ecchymoses widespread, thus mimicking vasculitis [ 63 ]. Some patients present alopecia or develop hair fragility; a particular hair growth called “corkscrew hairs” is also observed, although rarely.…”

Section: Discussionmentioning

confidence: 99%

A Narrative Review on Pediatric Scurvy: The Last Twenty Years

et al. 2022

View full text Add to dashboard Cite

Scurvy is a well-known clinical condition caused by vitamin C deficiency. Although considered a rare disease in high-income countries, it has been recently increasingly reported in children, especially in those with abnormal dietary habits, mental or physical disabilities. We performed an extensive review of the literature analyzing studies published in the last 20 years focusing on clinical features, differential diagnosis and diagnostic delay. Fifteen articles were selected, collectively reporting a total of 166 children. Because of the wide clinical spectrum (musculoskeletal complaints and/or mucocutaneous lesions or systemic symptoms), scurvy can mimic several conditions, including autoimmune diseases, infections, and neoplasia. In addition, frequent findings such as normal nutritional status, anemia or elevated inflammatory markers may guide clinicians towards the abovementioned misdiagnoses. Scurvy should be considered in patients presenting with musculoskeletal complaints, not only in those with risk factors but also in healthy children. A focused dietary history and a careful physical examination, assessing other signs of vitamin C deficiency, are mandatory in these patients. When suspected, the dosage of serum vitamin C is the diagnostic gold standard; furthermore, imaging studies, performed by an expert radiologist, can reveal the typical features of scurvy. Only early diagnosis can avoid unnecessary investigations and potentially fatal complications of the disease.

show abstract

Section: Discussionmentioning

confidence: 99%

A Narrative Review on Pediatric Scurvy: The Last Twenty Years

et al. 2022

View full text Add to dashboard Cite

show abstract

“…It should also be noted that elevated ESR and anemia are commonly seen in scurvy. [9][10][11] The relationship between scurvy and elevated ESR is not well understood. 9 Elevated C-reactive protein and fibrinogen are also seen in scurvy.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11] The relationship between scurvy and elevated ESR is not well understood. 9 Elevated C-reactive protein and fibrinogen are also seen in scurvy. 11 Anemia is often due to concurrent iron or folate deficiency and is also possibly due to chronic microhemorrhages, gastrointestinal losses, or intravascular hemolysis.…”

Section: Discussionmentioning

confidence: 99%

Scurvy Due to Selective Diet in a Seemingly Healthy 4-Year-Old Boy

et al. 2019

View full text Add to dashboard Cite

Scurvy is a rare disease in developed nations. In the field of pediatrics, it primarily is seen in children with developmental and behavioral issues, malabsorptive processes, or diseases involving dysphagia. We present the case of an otherwise developmentally appropriate 4-year-old boy who developed scurvy after gradual self-restriction of his diet. He initially presented with a limp and a rash and was subsequently found to have anemia and hematuria. A serum vitamin C level was undetectable, and after review of the MRI of his lower extremities, the clinical findings supported a diagnosis of scurvy. Although scurvy is rare in developed nations, this diagnosis should be considered in a patient with the clinical constellation of lower-extremity pain or arthralgias, a nonblanching rash, easy bleeding or bruising, fatigue, and anemia. This case highlights the importance of carefully assessing a child’s dietary and developmental status at well-child visits, which can help avoid a more invasive workup.

show abstract

“…Porosity of the orbital roof can result from a multitude of pathological conditions, including scurvy and vitamin D deficiency (Brickley et al, ; Klaus, ); therefore this potential co‐occurrence must be approached with caution. However, hemorrhaging and a reduced capacity for iron absorption associated with vitamin C deficiency may lead to the development of anemia, and in turn iron deficiency can impair absorption of nutrients such as calcium which therefore may propagate vitamin D deficiencies (Agarwal, Shaharyar, Kumar, Bhat, & Mishra, ; Baker, Greer,, & The Committee on Nutrition, ; Brickley et al, , p. 6; Ferrari , Possemato, Pipitone, Manger, & Salvarani, ; Wapler, Crubézy, & Schultz , ; Weinstein , Babyn, & Zlotkin, ). Cribra orbitalia is broadly related to unhygienic environments and dietary deficiencies; therefore its high prevalence within all of the samples and its potential association with metabolic disease is not surprising.…”

Section: Discussionmentioning

confidence: 99%

North and south: A comprehensive analysis of non‐adult growth and health in the industrial revolution (AD 18th–19th C), England

Newman

Gowland

Caffell

2019

American J Phys Anthropol

View full text Add to dashboard Cite

Objective: Stark health inequalities exist in the present day between the North and South of England, with people in the South, overall, experiencing better health across a range of parameters (e.g., life expectancy and number of years spent in good health). Bioarchaeological studies of skeletal remains from cemeteries across this geographical divide have the ability to provide a temporal perspective on the etiology, longevity, and nature of this disparity. Methods: In total 574 non-adults (0-17 years) from six urban sites (c. AD 1711-1856) were analyzed from the North and South of England. Measurements of long bone length, cortical thickness, and vertebral dimensions were analyzed alongside both skeletal and dental palaeopathological data to assess patterns of disease and growth disruption between skeletal samples. Results: There were few significant differences in growth parameters between the six sites in relation to geographical location. However, the northern-based sample Coach Lane (North Shields) demonstrated some of the highest rates of pathology, with metabolic disease being particularly prevalent. Discussion: Northern and southern populations suffered alike from the detrimental environmental conditions associated with urban centers of the 18th-19th centuries. However, the elevated prevalence of vitamin D deficiency seen within the Coach Lane sample is indicative of a regionally specific risk that may be related to latitude, and/or the influence of particular industries operating in the North-East. K E Y W O R D S palaeopathology, post-medieval, stature, vertebral growth, vitamin D deficiency

show abstract

Rheumatic Manifestations of Scurvy

Cited by 16 publications

References 22 publications

A Narrative Review on Pediatric Scurvy: The Last Twenty Years

A Narrative Review on Pediatric Scurvy: The Last Twenty Years

Scurvy Due to Selective Diet in a Seemingly Healthy 4-Year-Old Boy

North and south: A comprehensive analysis of non‐adult growth and health in the industrial revolution (AD 18th–19th C), England

Contact Info

Product

Resources

About