eMedicine Specialties > Pediatrics: General Medicine > Nutrition

Scurvy: Follow-up

Author: Bradley S Buckler, MD, Fellow in Neonatal-Perinatal Medicine, Medical College of Georgia
Coauthor(s): Anjali Parish, MD, Assistant Professor of Pediatrics, Department of Neonatology, Medical College of Georgia
Contributor Information and Disclosures

Updated: Jul 16, 2009

Follow-up

Further Inpatient Care

  • Because sudden death may occur in patients with scurvy, ensuring adequate vitamin C replenishment in patients with vitamin C deficiency is the hallmark of therapy. Restoration of body stores of vitamin C is essential to achieve complete resolution of symptoms. In most adult patients, provision of 250 mg of vitamin C 4 times a day for 1 week aids in achieving this goal.
  • Provision of a balanced and liberal diet to meet the nutritional needs of the patient aids in recovery.
  • Identifying and treating comorbid nutritional deficiencies (eg, iron deficiency anemia, folate deficiency, other vitamin deficiencies) are integral parts of management.

Further Outpatient Care

  • Supervising the diet to ensure adequate intake of vitamin C to effect complete resolution and prevent recurrence.

Deterrence/Prevention

  • Scurvy is a preventable disease. Provision of the required daily allowance of vitamin C in the diet or as a supplement prevents scurvy.

Complications

  • Scurvy, if left untreated, can be fatal and has been associated with sudden death.
  • Morbidity associated with hemorrhages depends on the site of involvement. Subperiosteal hemorrhages cause pain and tenderness resulting in pseudoparalysis. Loss of function at the site of the hemorrhage and anemia are typical sequelae of the hemorrhages observed in scurvy.

Prognosis

  • Typically, scurvy carries an excellent prognosis if diagnosed and treated appropriately.

Miscellaneous

Medicolegal Pitfalls

  • The bony pathology associated with scurvy could potentially be confused with physical abuse of a child. A good dietary history and the response to treatment with vitamin C establish the diagnosis and clear confusion. Nevertheless, in the developed world, vitamin C deficiency in children may be associated with neglect (ie, nutritionally inadequate diet) as a form of child abuse, even in the absence of overt signs of physical trauma.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknolwedge the contributions of previous author Kumaravel Rajakumar, MD, to the original writing and development of this article.



More on Scurvy

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Differential Diagnoses & Workup: Scurvy
Treatment & Medication: Scurvy
Follow-up: Scurvy
Multimedia: Scurvy
References
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Further Reading

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Keywords

scurvy, vitamin C deficiency, infantile scurvy, Barlow disease, Barlow's disease, Cheadle disease, Cheadle's disease, osteopathia hemorrhagica infantum, scurvy rickets, deficiency of ascorbic acid, impaired collagen synthesis, defective collagen, defective dentine formation, hemorrhaging

hemorrhaging into the gums, subperiosteal hemorrhage, pseudoparalysis, costochondral beading, scorbutic rosary, hyperkeratosis, corkscrew hair, sicca syndrome, whiteline of Frãnkel, treatment, diagnosis

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Contributor Information and Disclosures

Author

Bradley S Buckler, MD, Fellow in Neonatal-Perinatal Medicine, Medical College of Georgia
Disclosure: Nothing to disclose.

Coauthor(s)

Anjali Parish, MD, Assistant Professor of Pediatrics, Department of Neonatology, Medical College of Georgia
Anjali Parish, MD is a member of the following medical societies: American Academy of Pediatrics and American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Steven M Schwarz, MD, FAAP, FACN, AGAF, Professor of Pediatrics, Children's Hospital at Downstate, SUNY-Downstate Medical Center
Steven M Schwarz, MD, FAAP, FACN, AGAF is a member of the following medical societies: American Academy of Pediatrics, American College of Nutrition, American College of Physician Executives, American Gastroenterological Association, American Pediatric Society, Gastroenterology Research Group, New York Academy of Medicine, North American Society for Pediatric Gastroenterology and Nutrition, and Society for Pediatric Research
Disclosure: TAP Pharmaceuticals Honoraria Speaking and teaching; Curemark, LLC Consulting fee Board membership; Centocor, Inc. Grant/research funds Independent contractor

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

CME Editor

Merrily P M Poth, MD, Professor, Department of Pediatrics and Neuroscience, Uniformed Services University of the Health Sciences
Merrily P M Poth, MD is a member of the following medical societies: American Academy of Pediatrics, Endocrine Society, and Lawson-Wilkins Pediatric Endocrine Society
Disclosure: Nothing to disclose.

Chief Editor

Jatinder Bhatia, MBBS, Professor of Pediatrics, Chief, Section of Neonatology, Department of Pediatrics, Medical College of Georgia
Jatinder Bhatia, MBBS is a member of the following medical societies: American Academy of Pediatrics, American Association for the Advancement of Science, American Dietetic Association, American Federation for Clinical Research, American Pediatric Society, American Society for Clinical Nutrition, American Society for Parenteral and Enteral Nutrition, New York Academy of Sciences, Society for Pediatric Research, and Southern Society for Pediatric Research
Disclosure: Mead Johnson Consulting fee Consulting; Mead Johnson Honoraria Speaking and teaching; Dey LP Consulting fee Consulting; Dey LP Honoraria Speaking and teaching; Ovation Honoraria Speaking and teaching

 
 
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