Scurvy in an alcoholic malnourished cirrhotic man with spontaneous bacterial peritonitis

Maltos, André Luiz; Portari, Guilherme Vannucchi; Saldanha, João Carlos; Júnior, Aderbal Garcia Bernardes; Pardi, Guilherme Rocha; Cunha, Daniel Ferreira da

doi:10.6061/clinics/2012(04)16

Cited by 10 publications

(8 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The authors observed a strong association between hypovitaminosis C and the presence of APR . Gariballa and Foster showed the effect of APR on nutrition status and acute phase proteins serum levels, which were inversely proportional to serum vitamin C levels, suggesting that the APR could be the cause of the observed hypovitaminosis C. Therefore, lower serum vitamin C levels among more severely malnourished patients could be associated with decreased food intake, malabsorption, and increased body nutrient consumption, as occurred in malnourished adults with human immunodeficiency virus or spontaneous bacterial peritonitis …”

Section: Discussionmentioning

confidence: 98%

“…Because we have observed low serum vitamin C levels and even overt scurvy in malnourished adults at our hospital, 22,23 we hypothesized that patients classified as C or B in the SGA would have lower vitamin C serum levels than SGA A patients. The aim of this study was to compare serum vitamin C among patients classified as A, B, or C in the SGA method.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Vitamin C Status in Hospitalized Adults According to Subjective Global Assessment Method

Avelino

Maltos

Portari

et al. 2018

J Parenter Enteral Nutr

Self Cite

View full text Add to dashboard Cite

Background The subjective global assessment (SGA) is a powerful tool for nutrition status assessment. Our aim was to compare vitamin C serum levels among patients classified as A, B, or C in the SGA. Methods One hundred‐and‐fifty adults in the wards of the University Hospital participated in this study. Besides SGA, all cases were submitted to anthropometry, bioelectrical impedance analysis (BIA), and 24‐hour dietary recall. Laboratory data included blood hemoglobin, serum ferritin, serum albumin, transferrin, C‐reactive protein (CRP), and vitamin C. Acute phase response was defined by serum CRP > 0.5 mg/dL; low serum vitamin C was defined by serum levels < 0.4 mg/dL. Analysis of variance and χ2 tests were used to compare groups; P < 0.05 was considered significant. Results Patients were diagnosed as SGA A (n = 76), B (n = 38), or C (n = 36) and showed different anthropometry and BIA. The same occurred, respectively, with vitamin C (median; range, in mg/day) intake (55.0; 4.7–140.6 vs 34.0; 10.3–244.2 vs 15.8; 2.3–124.0) and high (%) CRP (88.3 vs 65.8 vs 48.7) and low (%) vitamin C serum levels (21.1 vs 34.2 vs 63.9). Conclusion Patients with worst nutrition parameters (SGA C) showed lower ascorbic acid serum levels than those classified as SGA A or B. These results are in accordance with reduced vitamin C intake and the presence of acute phase response.

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Vitamin C Status in Hospitalized Adults According to Subjective Global Assessment Method

Avelino

Maltos

Portari

et al. 2018

J Parenter Enteral Nutr

Self Cite

View full text Add to dashboard Cite

show abstract

“…Although full-blown vitamin C deficiency is currently uncommon in Western countries, sporadic cases of scurvy have been described in malnourished patients including alcoholics [40,41]. That prompts for careful skin examination and ascorbic acid measurements when available in this setting [41].…”

Section: Other Nutritional Deficienciesmentioning

confidence: 99%

“…That prompts for careful skin examination and ascorbic acid measurements when available in this setting [41].…”

Section: Other Nutritional Deficienciesmentioning

confidence: 99%

Diagnosis and treatment of nutritional deficiencies in alcoholic liver disease: Overview of available evidence and open issues

Rossi

Conte

Massironi

2015

Digestive and Liver Disease

View full text Add to dashboard Cite

Malnutrition is common in alcoholic liver disease and is associated with high rates of complications and mortality. In this article, the current literature was reviewed to highlight the relevance of proper nutritional management providing levels of evidence, when available. A PubMed search was performed for English-language publications from 1980 through 2014 with the keywords: alcoholic liver disease, nutritional deficiencies, nutritional support, enteral nutrition, parenteral nutrition, and protein-energy malnutrition. Manuscripts focused on nutritional approach in patients with alcoholic liver disease were selected. Although nutritional support for malnourished patients improves the outcome of hospitalization, surgery, transplantation and reduces the complications of liver disease and the length of hospital stay, specific guidelines are scanty. Both enteral and parenteral nutrition appear to improve nutritional parameters and liver function; however data on survival is often conflicting. As micronutrient depletion is common in alcoholic liver disease and each deficiency produces specific sequelae, all cirrhotic patients should be screened at baseline for deficiencies of micronutrient and supplemented as needed. In summary, protein-energy malnutrition and micronutrient depletion are clinical concerns in alcoholic liver disease. Nutritional therapy, including enteral nutrition, parenteral nutrition and micronutrient supplementation should be part of the multidisciplinary management of these patients.

show abstract

“…3 While infrequently diagnosed in the developed world, it is important to consider, especially for populations such as the elderly, alcohol abusers, drugs abusers, those who follow strict diets, those who have eating disorders, or those with malabsorption. 4,5 Early symptoms are nonspecific: fatigue, weakness, weight loss, myalgias, arthralgias, and irritability. This makes the diagnosis of scurvy challenging.…”

Section: Discussionmentioning

confidence: 99%

Scurvy in the Context of End-Stage Liver Disease

Aujnarain¹,

Ccpa²,

Wilson³

2016

Can Journ Gen Int Med

View full text Add to dashboard Cite

show abstract

Scurvy in an alcoholic malnourished cirrhotic man with spontaneous bacterial peritonitis

Cited by 10 publications

References 18 publications

Vitamin C Status in Hospitalized Adults According to Subjective Global Assessment Method

Vitamin C Status in Hospitalized Adults According to Subjective Global Assessment Method

Diagnosis and treatment of nutritional deficiencies in alcoholic liver disease: Overview of available evidence and open issues

Scurvy in the Context of End-Stage Liver Disease

Contact Info

Product

Resources

About