Medication Summary
The only effective therapy for scurvy is vitamin C replacement. Thus, the goal of treatment is to saturate the body rapidly with ascorbic acid; at maximum doses, body stores become saturated in a few days. With proper treatment, bleeding stops within 24 hours, and perifollicular petechiae resolve in 2 weeks.
Vitamins
Class Summary
Vitamins are organic substances required by the body in small amounts for various metabolic processes and are essential for normal DNA synthesis and cell function. Vitamins may be synthesized in small or insufficient amounts in the body or not synthesized at all, thus requiring supplementation. They are classified as either fat soluble or water soluble. Vitamins A, D, E, and K are fat soluble, whereas biotin, folic acid, niacin, pantothenic acid, the B vitamins (ie, B-1, B-2, B-6, B-12), and vitamin C are generally water soluble.
Vitamin deficiency may result from an inadequate diet, from increased requirements (eg, pregnancy, lactation), or secondary to disease or drugs. Vitamin supplements are used clinically for the prevention and treatment of specific vitamin-deficiency states.
Ascorbic acid (Vita-C, C-Gram, vitamin C, Dull-C, Acerola, Chew-C)
Ascorbic acid (vitamin C) administered orally or parenterally effectively cures infantile and adult scurvy. This vitamin is used by the body for collagen synthesis and tissue repair.
Leger D. Scurvy: reemergence of nutritional deficiencies. Can Fam Physician. Oct 2008;54(10):1403-6. [Medline]. [Full Text].
Delanghe JR, Langlois MR, De Buyzere ML, Torck MA. Vitamin C deficiency and scurvy are not only a dietary problem but are codetermined by the haptoglobin polymorphism. Clin Chem. Aug 2007;53(8):1397-400. [Medline].
Jenny C. Evaluating infants and young children with multiple fractures. Pediatrics. Sep 2006;118(3):1299-303. [Medline].
Gan R, Eintracht S, Hoffer LJ. Vitamin C deficiency in a university teaching hospital. J Am Coll Nutr. Jun 2008;27(3):428-33. [Medline].
Mosdol A, Erens B, Brunner EJ. Estimated prevalence and predictors of vitamin C deficiency within UK's low-income population. J Public Health (Oxf). Dec 2008;30(4):456-60. [Medline].
Biesalski HK. Parenteral ascorbic acid in haemodialysis patients. Curr Opin Clin Nutr Metab Care. Nov 2008;11(6):741-6. [Medline].
Singer R, Rhodes HC, Chin G, et al. High prevalence of ascorbate deficiency in an Australian peritoneal dialysis population. Nephrology (Carlton). Feb 2008;13(1):17-22. [Medline].
Hampl JS, Taylor CA, Johnston CS. Vitamin C deficiency and depletion in the United States: the Third National Health and Nutrition Examination Survey, 1988 to 1994. Am J Public Health. May 2004;94(5):870-5. [Medline]. [Full Text].
Noble JM, Mandel A, Patterson MC. Scurvy and rickets masked by chronic neurologic illness: revisiting "psychologic malnutrition". Pediatrics. Mar 2007;119(3):e783-90. [Medline].
Duggan CP, Westra SJ, Rosenberg AE. Case records of the Massachusetts General Hospital. Case 23-2007. A 9-year-old boy with bone pain, rash, and gingival hypertrophy. N Engl J Med. Jul 26 2007;357(4):392-400. [Medline].
Arron ST, Liao W, Maurer T. Scurvy: a presenting sign of psychosis. J Am Acad Dermatol. Aug 2007;57(2 Suppl):S8-10. [Medline].
Hercberg S, Preziosi P, Galan P, et al. Vitamin status of a healthy French population: dietary intakes and biochemical markers. Int J Vitam Nutr Res. 1994;64(3):220-32. [Medline].
Ratanachu-Ek S, Sukswai P, Jeerathanyasakun Y. Scurvy in pediatric patients: a review of 28 cases. J Med Assoc Thai. Aug 2003;86 Suppl 3:S734-40. [Medline].
Toffanello ED, Inelmen EM, Minicuci N, et al. Ten-year trends in vitamin intake in free-living healthy elderly people: the risk of subclinical malnutrition. J Nutr Health Aging. Feb 2011;15(2):99-103. [Medline].
Tveden-Nyborg P, Lykkesfeldt J. Does vitamin C deficiency result in impaired brain development in infants?. Redox Rep. 2009;14(1):2-6. [Medline].
Ragunatha S, Inamadar AC, Palit A, et al. Diffuse nonscarring alopecia of scalp: an indicator of early infantile scurvy?. Pediatr Dermatol. Nov-Dec 2008;25(6):644-6. [Medline].
World Health Organization/NHD 99.11 Scurvy and its prevention and control in major emergencies. World Health Organization. Available at http://www.who.int/nutrition/publications/emergencies/WHO_NHD_99.11/en/. Accessed July 28, 2011.
Emadi-Konjin P, Verjee Z, Levin AV, Adeli K. Measurement of intracellular vitamin C levels in human lymphocytes by reverse phase high performance liquid chromatography (HPLC). Clin Biochem. May 2005;38(5):450-6. [Medline].
Dietary Reference Intakes from the Food and Nutrition Board, Institute of Medicine, National Academies. Available at http://iom.edu/Activities/Nutrition/SummaryDRIs/~/media/Files/Activity%20Files/Nutrition/DRIs/RDA%20and%20AIs_Vitamin%20and%20Elements.pdf. Accessed July 28, 2011.

