Scurvy

Scurvy is a condition resulting from severe, prolonged vitamin C deficiency, causing weakness, gum disease, and bleeding due to impaired collagen formation. It is uncommon where fresh fruits and vegetables are regularly available, but can occur with very restricted diets.

• Fatigue and weakness
• Swollen, bleeding gums, and, in children, delayed wound healing
• Easy bruising and small areas of bleeding under the skin, particularly around hair follicles
• Joint pain and swelling, especially in children, sometimes with reluctance to move the affected limb
• Poor wound healing

• Results from prolonged, severe dietary vitamin C deficiency, since the body cannot produce vitamin C itself and relies entirely on dietary intake.
• Risk is increased by very restricted diets lacking fresh fruits and vegetables, food insecurity, and certain conditions affecting nutrient intake or absorption.
• Symptoms typically take several months of significant deficiency to develop.

• Suspected clinically based on the characteristic combination of gum disease, bleeding tendencies, and joint symptoms together with a history of very limited fruit and vegetable intake.
• Blood testing for vitamin C levels, where available, can confirm the diagnosis, though treatment is often started based on strong clinical suspicion given the characteristic presentation.

Vitamin C supplementation leads to rapid and significant improvement, often within days for the bleeding and gum symptoms, with fuller recovery over subsequent weeks.

Dietary counselling to include regular vitamin C-rich foods, such as citrus fruits and certain vegetables, supports both treatment and prevention of recurrence.

Any underlying cause of restricted diet, such as food insecurity, is addressed as part of comprehensive management.

Prompt treatment generally leads to a full recovery, though joint and bone changes in children may take longer to resolve.

• Ensure regular intake of vitamin C-rich foods, such as citrus fruits, guava, and certain vegetables, as part of a balanced diet.
• Be particularly attentive to nutrient adequacy in very restricted diets, whether due to food insecurity, specific health conditions, or other reasons.
• Seek nutritional assessment and support for anyone with a persistently very limited diet.