Diseases List

ID 163
Name SCURVY
Cause
Signs Symptoms
Diagnosis
Investigations Investigations: 1 X-ray of long bones may show subperiosteal hemorrhages. 2. Capillary fragility test is positive. 3. Vitamin C level of serum, white cells and platelets is reduced.
Management
Introduction Scurvy is a disease of connective tissue due to deficiency of Vitamin C characterised by weakness, ulceration of gum and hemorrhage in skin and subcutaneous tissue due to defective formation of collagen in connective tissue because of failure of hydroxylation of proline to hydroxyproline
History
Etiology Etiology: 1. Due to malabsorption from any cause e.g. partial gastrectomy. 2. Due to direct dietary deficiency of vitamin C. 3. Chronic renal disorders. 4. Prolonged lactation and frequent pregnancy. 5. Lack of sun-light.
Clinical Features Clinical features: A. Adult scurvy- The pathognomonic sign is the swollen and spongy gums. The teeth may become loose and even fall out, there is always infection and offensive fetor. The first sign of cutaneous bleeding is often found in lower thighs, there is perifollicular hemorrhages and ‘corkscrew’ hair. Perifollicular hemorrhages are often followed by petichial hemorrhage usually first seen on the feet and ankles. Thereafter large spontaneous bruises may arise anywhere but usually first in lower extremities, producing the characteristic woody leg. Hemorrhage may occur into joints, under nails, conjunctiva or in GI tract, there may be epistaxis. Another characteristic of scurvy is that fresh wound fails to heal. A patient with scurvy may die suddenly from cardiac failure. B. Infantile scurvy- The main clinical features are lassitude, anorexia anemia, painful limbs and enlargement of the costochondral junctions, gingivitis. There may be subperiosteal hemorrhage in one of the long bones which gives rise to intense pain, especially on movement.
Preventions
Treatment Treatment: 1. Vitamin C (ascorbic acid) should be given 250mg orally 8 hourly for a long days. A daily intake of more than Igm may cause diarrhea and formation of renal oxalate stones. 2. If the patient is anemic iron and sometimes folic acid are indicated. 3. Fresh fruits and vegetable should be taken.
Complications
Prognosis
Types
Classification
Observation
Pathology
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