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J Pediatr 2019 Feb 6. Epub 2019 Feb 6.

Section of Cardiology, Department of Pediatrics, University of Colorado Denver School of Medicine, Aurora, Colorado.

Blood Cells Mol Dis 2019 Jan 24. Epub 2019 Jan 24.

Division of Hematopathology and Transfusion Medicine, University of Ottawa, Canada.

Background: Scurvy is a rare entity in developed countries and the diagnosis may often be delayed resulting in unnecessary investigations and/or potentially severe complications. A recent increase in the number of patients diagnosed with scurvy in our hematology clinics indicated the need to review the literature on the diagnosis and optimal management of similar patients.

Methods: We conducted a retrospective chart review of patients referred to hematology at our tertiary care centre between 2010 and 2018, who were ultimately diagnosed with scurvy. Read More

MMWR Morb Mortal Wkly Rep 2019 Jan 25;68(3):72-75. Epub 2019 Jan 25.

Scurvy is a relatively rare micronutrient deficiency disease that can occur among refugees dependent on food aid (1). Inadequate access to fresh fruits and vegetables in refugee camps can result in scurvy (2,3). Kakuma Refugee Camp in Kenya's Turkana District is home to 148,000 refugees, mostly from Somalia and South Sudan, who receive food assistance. Read More

Int J Hematol 2019 Jan 22. Epub 2019 Jan 22.

Department of Hematology-Oncology, Allegheny Health Network, Pittsburgh, PA, USA.

Historically known to be a disease of sailors and soldiers in the seventeenth and eighteenth century, scurvy is a rare nutritional deficiency in the developed world, but it can still be seen among the alcoholics and the malnourished. We present a case of a 39-year-old alcoholic male who presented with progressive fatigue and diffuse purpuric rash with scattered ecchymosis for 2 months. Blood work was remarkable for hemoglobin of 9. Read More

Clin Med (Lond) 2019 Jan;19(1):22-25

Queen Elizabeth Hospital Birmingham, Birmingham, UK.

Royal Naval ships' companies, isolated by hundreds of miles of sea with contacts to the outside world tightly regulated, provided perfect environments to study the epidemiology of disease. In 1747, James Lind organised one of the earliest clinical trials, demonstrating that scurvy could be treated by lemon juice. A century later, Alexander Bryson proved the value of careful epidemiological data collection and observation of infectious diseases encountered on the West Africa station. Read More

Am J Hematol 2019 Jan 13. Epub 2019 Jan 13.

Division of Pediatric Hematology, Oncology & HSCT Center, Department of Pediatrics, Erciyes University, Faculty of Medicine, Kayseri, Turkey.

Indian J Anaesth 2018 Dec;62(12):927-929

Critical Care Department, AMRI Hospital, Kolkata, West Bengal, India. E-mail:

Acta Derm Venereol 2019 Jan 9. Epub 2019 Jan 9.

Department of Dermatology and Venereology, Skåne University Hospital, SE-205 02 Malmö, Sweden.

Int Orthop 2019 Jan 9. Epub 2019 Jan 9.

Hôpital Henri Mondor, 94010, Creteil, France.

Purpose: After Glisson's description of rickets, it took two centuries to realize that rickets was due to the absence of antirachitic nutrients in the diet or lack exposure of the skin to ultraviolet rays. This bone disease caused by vitamin D deficiency was one of the most common diseases of children 100 years ago. This paper explores how the definition, diagnosis, and treatment of rickets shifted in the first decades of the twentieth century. Read More

J Clin Med Res 2019 Jan 3;11(1):26-34. Epub 2018 Dec 3.

Nouvelle Clinique des Trois Frontieres, 8, rue Saint Damien 68300 Saint-Louis, France.

Background: Little is known about the prevalence of vitamin C deficiency in the population of individuals who are withdrawing from alcohol, and about possible consequences of latent scurvy. The aim of this study was to evaluate the prevalence of vitamin C deficiency in patients who were withdrawing from alcohol, its correlation with latent scurvy (mainly tiredness and weakness) and the change in the latter symptoms at 3 months after oral vitamin C supplementation.

Methods: A total of 47 patients (33 males, 14 females) who volunteered to undertake alcohol detoxification were included prospectively between January 2014 and November 2016. Read More

CASE (Phila) 2018 Dec 5;2(6):279-281. Epub 2018 Oct 5.

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Int J Paleopathol 2018 12 6;23:76-87. Epub 2017 Dec 6.

Department of Earth Sciences, Natural History Museum, Cromwell Road, London, SW7 5BD, UK; AOC Archaeology Group, Moor Mead Road, Twickenham, TW1 1JS, UK. Electronic address:

Growing evidence suggests that vitamin D supports immune responses to infections, autoimmune conditions and cancers, although evidence from large-scale studies is limited. There is scope to better understand how vitamin D deficiency interacted with other diseases to affect health in past groups. This study investigated paleopathological evidence and documentary records of individual cause of death to examine disease co-occurrence in a group of mid-19th century child burials from London, UK. Read More

Acta Med Hist Adriat 2018 Dec;16(2):203-238

Clinical pathology, Stedelijk Ziekenhuis, Roeselare, Belgium.

A discussion is given of the figure of Johann Bachoven von Echt and his family, and on his work on scurvy. The disease is evaluated as a possible cause of the death of Andreas Vesalius. Echt's relationship with Jan Wier and his connections with Vesalius and Metellus are illustrated. Read More

Nutr Metab Insights 2018 21;11:1178638818809097. Epub 2018 Nov 21.

Department of Geriatric Medicine, Karin Grech Hospital, Pietà, Malta.

Background And Objective: Scurvy, caused by vitamin C deficiency, first described by Hippocrates, is known to many as 'The Pirates' Disease'. Although a disease rarely acknowledged in modern medicine, we present 2 cases of elderly gentlemen found to have scurvy, who improved significantly on treatment.

Methods: This study presents a case report of 2 patients undergoing rehabilitation at Karin Grech Hospital in Malta, noted to have signs and symptoms of vitamin C deficiency. Read More

Pediatr Emerg Care 2018 Nov 19. Epub 2018 Nov 19.

From the Department of Emergency Medicine (Pediatric Unit), College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.

Ketogenic diets used for treating various neurological disorders can have potentially serious adverse effects. Among these is scurvy, a rarely reported, yet potentially fatal adverse effect of the ketogenic diet caused by vitamin C deficiency. We report a case of a 5-year-old patient with autism, who presented with scurvy secondary to the dietary restrictions of a ketogenic diet. Read More

Afr J Prim Health Care Fam Med 2018 Oct 25;10(1):e1-e3. Epub 2018 Oct 25.

Family Medicine Department, Africa Inland Church, Kijabe Hospital.

Over a five-month period, clinicians in Tana River County Kenya observed an increasing number of patients presenting to health facilities with a common collection of symptoms including fevers, joint pains and gum hypertrophy. After initial investigative and management strategies failed to reveal a diagnosis, patients were empirically commenced on ascorbic acid for presumed scurvy. This strategy resulted in the rapid resolution of symptoms in 65 patients within two weeks. Read More

Vet Clin North Am Exot Anim Pract 2019 Jan;22(1):15-26

Ophthalmology, BluePearl Veterinary Partners, 1071 Howell Mill Road Northwest, Atlanta, GA 30318, USA. Electronic address:

This article discusses the clinical appearance, differential diagnoses, and treatment considerations of corneal disease in the most common domesticated species of rodent: mouse, rat, chinchilla, and guinea pig. Many corneal diseases are related to inbred strains of either research or pet rodents. Diseases are complicated by husbandry and treatment-related challenges in this small, social species. Read More

Rev Med Liege 2018 Nov;73(11):541-543

Gastro-entérologie, CHBA, Liège, Belgique.

Scurvy, a disease caused by a deficit in vitamin C, is again described in Europe nowadays. This condition is associated with poverty and malnutrition, as found in developing countries. However, denutrition may also occur with a "western" lifestyle that can lead to nutriment deficiencies. Read More

Am J Forensic Med Pathol 2019 Mar;40(1):43-46

School of Humanities, University of Tasmania, Hobart, Tasmania, Australia.

Scurvy is a multisystem condition that arises from vitamin C deficiency. As humans cannot synthesize vitamin C, serum and tissue levels depend on bioavailability, utilization, and renal excretion. Deficiencies result in defective collagen formation with swelling of gums, leg ulceration, and bleeding manifestations. Read More

Hemodial Int 2018 10 8;22(S2):S83-S87. Epub 2018 Nov 8.

Division of Nephrology, Department of Medicine, University of Missouri, CE425, 1 Hospital Drive, Columbia, Missouri 65212, USA.

Chronic kidney disease and dialysis brings with it a plethora of complications, including malnutrition. Strict dietary restrictions in hemodialysis (HD) patients further complicate the picture as it increases the risk of deficiency of micronutrients, specifically water-soluble vitamins. Today, there is a lack of concrete guidelines concerning recommendations on vitamin supplementation in HD patients. Read More

Skeletal Radiol 2018 Oct 29. Epub 2018 Oct 29.

Department of Radiology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland.

Scurvy is a disease that is rarely encountered in modern medicine. A condition that was classically associated with sailors, its incidence has decreased dramatically since the discovery of its association with vitamin C deficiency. We present the case of a 2-year-old boy, whose treatment for neuroblastoma was complicated by gastrointestinal disease, which necessitated enteral feeding. Read More

Pulm Circ 2019 Jan-Mar;9(1):2045894018812052. Epub 2018 Oct 23.

1 University of California San Francisco Benioff Children's Hospital - Oakland, Oakland, CA, USA.

We report a case of a six-year-old boy who presented after a cardiac arrest, likely due to a pulmonary hypertensive crisis in the setting of vitamin C deficiency. After initially presenting with subacute multifocal bone lesions of unknown etiology, he experienced a pulseless electrical activity cardiac arrest while undergoing a diagnostic procedure under sedation. During his post-arrest convalescence, he developed persistent tachycardia and peripheral edema. Read More

Sci Pharm 2018 Oct 7;86(4). Epub 2018 Oct 7.

Department of Clinical Pharmacy and Therapeutics, Applied Science Private University, 11931 Amman, Jordan.

Mediterranean-native perennial plant was scrutinized in this study for its antioxidant activity and its total phenolic content in order to test for the plant's wound-healing capability. The traditional uses of this plant to treat gum scurvy, various tumors, ulcers, and hemorrhoids were the main idea behind this study. Leaves and flowers of the were extracted by maceration. Read More

Am J Phys Anthropol 2018 Dec 9;167(4):876-895. Epub 2018 Oct 9.

Department of Anatomy, University of Otago, Dunedin, Otago, New Zealand.

The past two decades have seen a proliferation in bioarchaeological literature on the identification of scurvy, a disease caused by chronic vitamin C deficiency, in ancient human remains. This condition is one of the few nutritional deficiencies that can result in diagnostic osseous lesions. Scurvy is associated with low dietary diversity and its identification in human skeletal remains can provide important contextual information on subsistence strategy, resource allocation, and human-environmental interactions in past populations. Read More

Skeletal Radiol 2018 Sep 26. Epub 2018 Sep 26.

Department of Radiology, Penn State Milton S. Hershey Medical Center, 500 University Dr, Hershey, PA, 17033, USA.

A 69-year-old man presented with unilateral calf pain, swelling, and erythematous rash. He was initially treated with antibiotics for suspected cellulitis. A venous duplex ultrasound, performed to exclude deep venous thrombosis, revealed multiple heterogeneous hypoechoic foci of unknown etiology throughout the calf musculature. Read More

Homo 2018 Sep 5;69(5):217-226. Epub 2018 Sep 5.

Institute for Anthropological Research, Zagreb 10 000, Croatia.

In this study, we examine the scurvy associated skeletal lesions among juveniles from the late Medieval site Uzdolje-Grablje in Croatia. The study aims to establish a demographic pattern of scurvy using existing diagnostic criteria. The sample consists of 16 well-preserved and fairly complete juveniles, excavated from a cemetery dating to 1420-1920. Read More

Arch Argent Pediatr 2018 Oct;116(5):e684-e687

Departamento de Pediatría, Servicio de Clínica Pediátrica, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires.

Scurvy is a very uncommon entity in pediatric population. Some case reports have been published in infants fed with boiled milk, in patients with iron overload secondary to hematological diseases and in children with food restrictions secondary to neurodevelopmental disorders. We report a case of a 4-year-old male patient with a diagnosis of autism spectrum disorder, which developed scurvy secondary to a long-term selective eating habit without fruit or vegetable intake. Read More

Pathology 2018 Oct 31;50(6):654-658. Epub 2018 Aug 31.

Department of Surgery, Liverpool Hospital, Sydney, NSW, Australia; Faculty of Medicine, Department of Surgery, University of New South Wales, Sydney, NSW, Australia.

Vitamin C is an essential micronutrient in the human diet. While large population studies measuring vitamin C have been performed in other countries, there are few studies of deficiency in the Australian population. This study aimed to quantify vitamin C deficiency, identify scorbutic symptoms and examine dietary associations in a cohort of preoperative general surgical patients. Read More

Lancet 2018 08;392(10145):431

Department of Dermatology, Weill Cornell Medical School, New York, NY, USA. Electronic address:

Arch Dis Child 2018 Aug 7. Epub 2018 Aug 7.

General Pediatric and Infectious Disease Unit, University Department of Pediatrics, Bambino Gesù Children's Hospital, Rome, Italy.

We report three cases of scurvy in previously healthy children referred to us for leg pain and refusal to walk. All children had no significant medical history, symptoms had started months before and subtly advanced. Two of them presented with gingival hyperplasia and petechiae, another one reported night sweats and gingival bleeding in the past few weeks. Read More

Int J Paleopathol 2018 09 31;22:121-134. Epub 2018 Jul 31.

University of Fribourg, Institut du monde antique et byzantin, Rue P. Aeby 16, 1700, Fribourg, Switzerland; Hellenic Ministry of Culture, Ephorate of Antiquities of Chania, Sourmeli 24, 73132, Chania, Greece. Electronic address:

The study of Roman childhood has been the focus of research primarily using documentary and archaeological evidence, while relatively few non-adult skeletal assemblages have been analyzed. This paper presents the study of 93 non-adult individuals from four cemeteries in the Roman (1st-3rd c. CE) civitas capital of Aventicum (Avenches), Switzerland. Read More

Eur J Rheumatol 2018 Dec 13;5(4):283-284. Epub 2018 Feb 13.

Department of Pediatric Hematology, Erciyes University School of Medicine, Kayseri, Turkey.

Pediatrics 2018 Aug;142(2)

Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Historically linked to sea voyagers in the 18th century, scurvy has become extremely rare during the last century in developed countries. However, it is still present in some at-risk populations and often overlooked in pediatric patients with restricted diets due to behavioral, neurodevelopmental, or psychiatric problems. So far, the only known etiology of developing scurvy is nutritional deficiency of vitamin C. Read More

J Gen Intern Med 2018 Nov 27;33(11):2008-2009. Epub 2018 Jul 27.

Division of General Internal Medicine & Geriatrics, Oregon Health & Science University, Portland, OR, USA.

Eur Rev Med Pharmacol Sci 2018 Jul;22(13):4355-4358

Institute of Internal Medicine, Catholic University of the Sacred Heart, A. Gemelli, Hospital Foundation, School of Medicine, Rome, Italy.

Objective: Scurvy is defined as a deficiency of ascorbic acid, which is an essential exogenous vitamin in humans. Vitamin C is involved in collagen synthesis and its deficit can cause disorders of connective tissue. The most frequent symptoms are weakness, arthralgias, anorexia and depression, commonly associated with follicular hyperkeratosis and perifollicular hemorrhage, with purpura. Read More

N Engl J Med 2018 Jul;379(3):282-289

From the Departments of Medicine (S.E.B., W.P.S., F.C.S.), Pediatrics (F.C.S.), and Pathology (J.M.B.), Massachusetts General Hospital, and the Departments of Medicine (S.E.B., W.P.S., F.C.S.), Pediatrics (F.C.S.), and Pathology (J.M.B.), Harvard Medical School - both in Boston.

J Paediatr Child Health 2018 Dec 27;54(12):1375-1377. Epub 2018 Jun 27.

Department of Radiology, Sunshine Hospital, Melbourne, Victoria, Australia.

Fertil Steril 2018 06;109(6):988

Division of Reproductive Endocrinology and Infertility, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

J Periodontol 2018 Jun;89 Suppl 1:S74-S84

Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Japan.

Periodontal health is defined by absence of clinically detectable inflammation. There is a biological level of immune surveillance that is consistent with clinical gingival health and homeostasis. Clinical gingival health may be found in a periodontium that is intact, i. Read More

J Clin Periodontol 2018 Jun;45 Suppl 20:S68-S77

Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Japan.

Periodontal health is defined by absence of clinically detectable inflammation. There is a biological level of immune surveillance that is consistent with clinical gingival health and homeostasis. Clinical gingival health may be found in a periodontium that is intact, i. Read More

J Clin Psychopharmacol 2018 08;38(4):398-400

Department of Psychiatry Bicêtre University Hospital and Assistance Publique-Hôpitaux de Paris Le Kremlin Bicêtre, France Service d'Hématologie Biologique CHU BicêtreAssistance Publique-Hôpitaux de Paris INSERM UMR_S1176 Université Paris-Sud Université Paris-Saclay, Le Kremlin-BicêtreCentre de Référence de la Maladie de Willebrandand Centre de Référence des Pathologies Plaquettaires, France Department of Internal MedicineBicêtre University Hospital Assistance Publique-Hôpitaux de Paris Université Paris-Sud, Le Kremlin-BicêtreINSERM UMR 1184Immunologie des Maladies Virales et AutoimmunesUniversité Paris-Sud, Le Kremlin Bicêtreand CEA, DSV/iMETIDivision of Immuno-Virology IDMIT Paris, France Department of Psychiatry Bicêtre University Hospital and Assistance Publique-Hôpitaux de Paris Le Kremlin BicêtreCHU de Bicêtre, Université Paris-Saclay Université Paris-Sud; UVSQCESP; INSERM U1178Le Kremlin Bicêtre, France

Clin Pract Cases Emerg Med 2018 May 14;2(2):147-150. Epub 2018 Mar 14.

Wake Forest School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina.

Although the causes have changed, scurvy (vitamin C deficiency) is still diagnosed in developed countries. We report a case of an 18-year-old female who presented to our emergency department with thrombocytopenia, sinus tachycardia, hypotension, fatigue, gingival hyperplasia, knee effusion, petechiae and ecchymosis in lower extremities. The differential diagnosis included hematologic abnormalities, infectious etiologies, vasculitis and vitamin deficiency. Read More

Front Pediatr 2018 1;6:126. Epub 2018 May 1.

Pediatric Department, University of Florence, Anna Meyer Children Hospital, Florence, Italy.

Vitamin C deficiency is anecdotal in developed countries, mainly associated with underling clinical morbidities as autism or neurological impairment. Chronic insufficient dietary supply is responsible for vascular fragility and impaired bone formation, resulting in gingival bleeding, petechial lesions, articular and bone pain or limb swelling. Children may present anorexia, irritability, failure to thrive, limping or refusal to walk. Read More

Proc (Bayl Univ Med Cent) 2018 Apr 12;31(2):227-228. Epub 2018 Mar 12.

Department of Hematology and Oncology, Utica Park Clinic Oncology, Tulsa, Oklahoma.

Vitamin C deficiency may be common in third-world countries due to malnutrition, but it is currently rare in the USA. Initially, nonspecific symptoms like exhaustion and depression may make this disease difficult to diagnose until classical dermatological manifestations appear. Diagnosis mainly relies on clinical presentation, dietary history to identify risk factors, and dramatic recession of symptoms and signs following vitamin C therapy. Read More

J Dent Child (Chic) 2018 Jan;85(1):40-42

Department of Oral Pathology, Nair Hospital Dental College, Mumbai, India.

Localized gingival enlargement associated with vitamin C deficiency (scurvy) is rarely encountered in the modern era. The purpose of this paper is to report a case of extensive inflammatory gingival enlargement in the mandibular anterior region associated with vitamin C deficiency in a 10 year-old boy. There was a significant improvement of the gingival enlargement seven days after starting oral vitamin C supplementation. Read More

Clin Med (Lond) 2018 03;18(2):180-182

Northwick Park Hospital, London, UK

A 73-year-old man presented with bilateral leg pain and swelling, and no history of trauma or bleeding disorders. Clinical examination, biochemistry and magnetic resonance imaging of the thighs were suggestive of muscle haematomas. These progressed significantly during the admission, requiring blood transfusion. Read More

BMJ Case Rep 2018 Mar 30;2018. Epub 2018 Mar 30.

Department of Intensive Care, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina.

Scurvy is a nutritional disease caused by ascorbic acid deficiency and is potentially fatal. It was originally described in the 18th century by James Lind and associated with long sea voyages and insufficient citrus consumption. Its prevalence has declined markedly over the years but has still been described sporadically in certain countries. Read More