Skin, muscle and joint disease from the 17th century: scurvy

Abstract

We report three cases of scurvy, with differing musculoskeletal presentations, from a tertiary teaching hospital in Sydney, Australia. Case 1 was a man with cerebral palsy who presented with knee swelling following a minor injury. In Case 2, a patient with thalassaemia major presented with purpuric rash, difficulty walking and distal thigh swelling and ecchymosis. Case 3 was a man with Down's syndrome who presented with acute ankle arthritis. Scurvy in Cases 1 and 3 were related to abnormal dietary preferences, whereas in Case 2, scurvy was thought to be related to thalassaemia. All three cases responded rapidly to vitamin C replacement. The subjects did not appear malnourished as they had adequate carbohydrate and protein intake.

Vitamin C Can Shorten the Length of Stay in the ICU: A Meta-Analysis

“…According to case reports of scurvy, in addition to fatigue, anemia, bruising, hematomas, and different types of pain, vitamin C deficiency has been associated with various cardiovascular symptoms [67,68,69,70,71,72,73,74,75,76], dyspnea [64,70,71,72,73,74,75,76,77,78,79,80,81], lower limb edema [13,64,66,70,72,80,160,161,162,163,164,165,166,167,168,169,170,171,172,173,174,175], infection-type symptoms [66,67,68,73,160,161,165,167,174,175,176,177], bleeding in the gastrointestinal and other regions [76,164,172,175,177,178,…”

“…Furthermore, a comparison between plasma levels of ascorbate and pool sizes showed a very poor correlation… In general, it is fair to say that scurvy appeared when the body pool fell below 300 mg” ([56], p. 441). The most undisputable evidence of scurvy symptoms is that they disappear with vitamin C administration [13,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,160,161,162,163,164,165,166,167,168,169,170,171,172,173,174,175,176,177,178,179,180,181,182,183,184,185].…”