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Scurvy in Infant/Neonate
See also in: Oral Mucosal Lesion
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Scurvy in Infant/Neonate

See also in: Oral Mucosal Lesion
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Contributors: Christine S. Ahn MD, FAAD, William W. Huang MD, MPH, FAAD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Scurvy is an acquired condition caused by a deficiency of vitamin C (L-ascorbic acid). Humans are unable to synthesize vitamin C; hence, it must be consumed in the diet. Deficiency of this essential nutrient causes impaired collagen synthesis, which leads to poor wound healing, capillary fragility, and bone abnormalities. In developed countries, scurvy is primarily found in elderly, those who abuse alcohol, and infants and children.

Scurvy can present with wide clinical variation, including dermatologic, dental, bone, and systemic manifestations. Clinical features of scurvy may be observed within 8 weeks of inadequate intake of vitamin C. The initial symptoms include irritability, decreased appetite, and low-grade fever. Dermatologic signs include xerosis, hyperkeratosis, perifollicular hemorrhage, scattered petechiae and ecchymoses, and corkscrew hairs. Oral findings include swollen, friable gingiva. In children, scurvy can present with joint swelling and refusal to walk, and bone growth may be inhibited. Rare presentations of scurvy include proptosis due to orbital hemorrhage, skeletal muscle degeneration, cardiac hypertrophy, psychological changes, edema, and alopecia. Untreated, scurvy can be fatal; deaths have been reported due to infection, cerebral hemorrhage, or hemopericardium.

In pediatric populations, at-risk individuals include those with iron overload, neurologic disorders, a history of bone marrow transplant, and/or chemotherapy. Additionally, children with restricted diets, especially in the setting of autism or developmental delay, are at increased risk.

Codes

ICD10CM:
E54 – Ascorbic acid deficiency

SNOMEDCT:
76169001 – Scurvy

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Cutaneous manifestations:
Failure to walk or limb pain:
Oral mucosal manifestations:

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed: 10/04/2017
Last Updated: 10/11/2017
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Scurvy in Infant/Neonate
See also in: Oral Mucosal Lesion
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View all Images (9)
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Scurvy (Initial Stage) : Diarrhea, Fatigue, Fever, Malaise, Anorexia, Tachypnea
Clinical image of Scurvy
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