Scurvy: A Disease for All Ages, Not Just a Maritime Malady

November 1, 2024 2

Scurvy (vitamin C deficiency) is more common in children and isolated older adults with restrictive eating patterns and unhealthy habits like smoking and substance use disorders.

Scurvy: A Disease for All Ages, Not Just a Maritime Malady

Vitamin C deficiency (scurvy) is not just an 18th-century sailor’s disease, according to a case study of a 65-year-old woman with mobility issues and social isolation.

The Ongoing Battle Against Vitamin C Deficiency

In an article published in CMAJ (Canadian Medical Association Journal), clinicians describe how scurvy should be considered in patients with abnormal bleeding and nonspecific symptoms (1^✔ ✔Trusted Source
Scurvy in a 65-year-old woman with severely limited function and social supports

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The patient visited the emergency department at a downtown Toronto hospital for leg pain and weakness, skin lesions, and discoloration. She also had several chronic health conditions. Her ability to go grocery shopping, cook, and perform other activities of daily living was restricted because of mobility issues, and she had little outside support. She subsisted largely on canned soup and fish, with no fresh produce.

“This case presents a complex example of food insecurity manifesting as an uncommon diagnosis,” said Dr. Sarah Engelhart, a general internist at Mount Sinai Hospital and the University of Toronto, Toronto, Ontario. “A unifying diagnosis was uncovered only after a detailed assessment of her social and dietary history.”

Scurvy Strikes Again

Vitamin C deficiency is more common than expected in the 21st century, with a 5.9% prevalence in the United States and rates possibly as high as 25% in some groups with low socioeconomic status in the United Kingdom.

As symptoms are often nonspecific, such as fatigue, weakness, and shortness of breath, diagnosis can be challenging.

Does Smoking Cause Vitamin C Deficiency?

The patient also smoked, which contributes to vitamin C deficiency. Once started on vitamin C treatment, her symptoms improved, and a blood test for vitamin C deficiency eventually confirmed the diagnosis.

Tracking Vitamin C Deficiency

Clinicians should be alert to vitamin C deficiency when assessing patients, including children and isolated older adults, with restrictive eating patterns (e.g., autism spectrum disorder or tea and toast diet), who smoke cigarettes, who have a substance use disorder, or who have malabsorption syndrome. The authors urge vigilance in assessing for food insecurity, which is a risk factor and affects about 1 in 5 Canadian households.

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