What is the name for a nutritional disease caused by a lack of vitamin c?

Option B

Scurvy is a condition characterised by general weakness, anaemia, gingivitis (gum disease), and skin haemorrhages caused by a prolonged deficiency of vitamin C (ascorbic acid) in the diet. Vitamin C plays a crucial role in the formation of collagen, a major component of connective tissue. Connective tissue has structural and supportive functions which are indispensable to blood vessels and all tissues within the body. Vitamin C is also important in the proper functioning of the immune system, iron absorption, cholesterol metabolism and other biological activities. Thus scurvy has widespread effects.

Who gets scurvy?

• Alcoholics
• Elderly
• Men who live alone (bachelor or widower scurvy)
• Children
• People on peculiar diets or food fads
• Psychiatric disease (delusions or fear of food, suicide attempt by self-starvation, eating disorders)
• Dialysis patients
• Inflammatory bowel disease (Crohns Disease)
• Malabsorption disorders
• Severe dyspepsi

Signs and Symptoms of scurvy

The diagnosis of scurvy is primarily a clinical one, based on a dietary history of inadequate vitamin C intake and the signs and symptoms described below.

Symptoms of scurvy generally develop after at least 3 months of severe or total vitamin C deficiency. Patients initially complain of weakness, fatigue, listlessness and aching limbs, especially in the legs. If left untreated, scurvy can progress to the following more severe problems.

Skin problems – one of the first signs of scurvy is the development of perifollicular hyperkeratotic papules, often on the shins. These appear as reddish/bluish bruise-like spots surrounding hair follicles. The central hairs are twisted like corkscrews that may break easily. The papules may join together to form large areas of palpable purpura or ecchymoses (bruises).

• Oral problems – gums may swell and become red, soft and spongy. Any slight friction may cause the gums to bleed. Often this results in poor oral hygiene and dental diseases.
• Musculoskeletal problems – bleeding in the joints causes extreme discomfort and pain. Joints may be swollen and tender and the pain can be so severe that patients cannot walk.
• Eye problems – patients may complain of dryness, irritation, light intolerance, transient visual blurring and stickiness. Haemorrhaging (bleeding) beneath the conjunctiva and within the optic nerve sheath may also occur.
• Anaemia – this develops in 75% of patients as a result of blood loss into tissue, altered absorptions and metabolism of iron and folate, gastrointestinal bleeding and intravascular haemolysis.
• Heart and lung problems – shortness of breath, low blood pressure, and chest pain leading to shock and death.

How is scurvy diagnosed?

Scurvy is diagnosed in someone with typical signs and symptoms, after taking a dietary history in which a low intake of fresh fruit and vegetables is identified. It is confirmed by a blood test for ascorbic acid showing levels < 11 µmol/L, and response of symptoms to treatment with vitamin C supplements and/or fresh fruit and vegetables.