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    Bruising in a Depressed Patient: Self-Inflicted or Adverse Effect of Antidepressants?: An Unexpected Cause: Scurvy.
    J Clin Psychopharmacol 2018 Jun 15. Epub 2018 Jun 15.
    Department of Psychiatry Bicêtre University Hospital and Assistance Publique-Hôpitaux de Paris Le Kremlin Bicêtre, France Service d'Hématologie Biologique CHU Bicêtre Assistance Publique-Hôpitaux de Paris INSERM UMR_S1176 Université Paris-Sud Université Paris-Saclay, Le Kremlin-Bicêtre Centre de Référence de la Maladie de Willebrand and Centre de Référence des Pathologies Plaquettaires, France Department of Internal Medicine Bicêtre University Hospital Assistance Publique-Hôpitaux de Paris Université Paris-Sud, Le Kremlin-Bicêtre INSERM UMR 1184 Immunologie des Maladies Virales et Autoimmunes Université Paris-Sud, Le Kremlin Bicêtre and CEA, DSV/iMETI Division of Immuno-Virology IDMIT Paris, France Department of Psychiatry Bicêtre University Hospital and Assistance Publique-Hôpitaux de Paris Le Kremlin Bicêtre CHU de Bicêtre, Université Paris-Saclay Université Paris-Sud; UVSQ CESP; INSERM U1178 Le Kremlin Bicêtre, France

    Scurvy: Dietary Discretion in a Developed Country.
    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

    Pediatric Scurvy: When Contemporary Eating Habits Bring Back the Past.
    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

    Scurvy in 2017 in the USA.
    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

    Gingival Enlargement Caused by Vitamin C Deficiency (Scurvy) in a Boy.
    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

    Photoexposed skin, skin aging, bateman purpura and local vitamin c deficiency.
    J Eur Acad Dermatol Venereol 2018 Apr 6. Epub 2018 Apr 6.
    University of Franche-Comté, BESANCON FRANCE.
    In a recent paper (1), Humbert et al proved the role of vitamin C deficiency in Bateman purpura. The mechanism described as a localized scurvy has be determined by comparison of clinical symptoms of scurvy and Bateman purpura, by knowledge of lower intra-dermal vitamin C levels in the skin in aged people, by the benefit of topical vitamin C determined using a double-blind randomized placebo controlled study. Indeed Bateman purpura is characterized by ecchymosis, atrophic skin, and thin dermis, stellar scars, and depigmentation. Read More

    Lesson of the month 1: Massive spontaneous haematomas in an elderly man.
    Clin Med (Lond) 2018 Mar;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

    Adult scurvy associated with psychiatric disorders and breast feeding.
    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

    An Unexpected Case of Scurvy in a Peritoneal Dialysis Patient.
    Case Rep Nephrol Dial 2017 Sep-Dec;7(3):172-177. Epub 2017 Dec 22.
    Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
    This case describes an obese adult male peritoneal dialysis patient who presented with a pruritic follicular rash. Nutrient deficiency was not suspected initially in this case because there was no history of protein-calorie malnutrition, but the patient reported a diet devoid of fruits and vegetables and had not been taking his dialysis vitamin as prescribed. Skin biopsy showed follicular hyperkeratosis with fragmented hair shafts and corkscrew hairs consistent with scurvy. Read More

    Assessing childhood stress in early mediaeval Croatia by using multiple lines of inquiry.
    Anthropol Anz 2018 May;75(2):155-167
    Anthropological Centre, Croatian Academy of Sciences and Arts, Zagreb, Croatia.
    Abstract: Childhood stress, using both subadult and adult remains from early mediaeval (8-11 c. CE) sites on the eastern Adriatic coast is analysed in this report. A total of 242 individuals (83 subadults, 69 adult females, and 90 adult males) were assessed for the presence of linear enamel hypoplasia, cribra orbitalia, sub-periosteal new bone formation, and scurvy. Read More

    James Lind and the disclosure of failure.
    J R Coll Physicians Edinb 2017 Dec;47(4):384-387
    S Justman, University of Montana, 1703 Maurice Ave, Missoula, MT 59801, USA. Email:
    Though James Lind is renowned as a pioneer of the clinical trial, he records the 1747 trial aboard the Salisbury in passing, never followed up on it, never campaigned for clinical trials as a means of medical discovery, and eventually pronounced scurvy an insoluble enigma. The case can be made that in confessing his lack of an unfailing remedy for scurvy and his trouble making sense of the disease's behaviour, Lind did medicine a greater service than by conducting his now-famous trial. At the time, medical progress was hindered by the all-too-common practice of proclaiming success and concealing failure. Read More

    Comment upon "Basilar portion porosity: A pathological lesion possibly associated with infantile scurvy".
    Int J Paleopathol 2018 Mar 10;20:114-115. Epub 2017 Oct 10.
    Laboratorio de Poblaciones del Pasado (LAPP), Departamento de Biología, Facultad de Ciencias, Universidad Autónoma de Madrid, Campus de Cantoblanco, 28049 Madrid, Spain. Electronic address:

    Dietary Vitamin C in Human Health.
    Adv Food Nutr Res 2018;83:281-310. Epub 2018 Feb 16.
    Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada. Electronic address:
    Vitamin C is essential to prevent scurvy in humans and is implicated in the primary prevention of common and complex diseases such as coronary heart disease, stroke, and cancer. This chapter reviews the latest knowledge about dietary vitamin C in human health with an emphasis on studies of the molecular mechanisms of vitamin C maintenance as well as gene-nutrient interactions modifying these relationships. Epidemiological evidence indicates 5% prevalence for vitamin C deficiency and 13% prevalence for suboptimal status even in industrialized countries. Read More

    Scurvy as a mimicker of osteomyelitis in a child with autism spectrum disorder.
    Int J Infect Dis 2018 Apr 6;69:99-102. Epub 2018 Feb 6.
    Division of Infectious Diseases, The Hospital for Sick Children, Toronto, Ontario, Canada. Electronic address:
    A case of scurvy in a 10-year-old boy with autism spectrum disorder is described. His clinical presentation was initially thought to be due to osteomyelitis, for which empirical antimicrobial therapy was initiated. Further invasive and ultimately unnecessary investigations were avoided when scurvy was considered in the context of a restricted diet and classic signs of vitamin C deficiency. Read More

    Latent scurvy with tiredness and leg pain in alcoholics: An underestimated disease three case reports.
    Medicine (Baltimore) 2017 Nov;96(47):e8861
    Rationale: Scurvy is often diagnosed at the state of well-established signs as, for example, skin and visceral purpura, gums involvement, loss of healthy teeth, which derive mostly from disturbance of collagen metabolism. Little is known about the state of latent scurvy, which symptoms are nonspecific and may mimic more common conditions such as weakness, leg pain, and muscle aching.

    Patient Concerns: We report 3 cases of extreme lassitude and leg pain in alcoholics. Read More

    Do You C What I C: Emergency Department Evaluation and Diagnosis of Pediatric Scurvy in an Autistic Child With a Restricted Diet.
    Pediatr Emerg Care 2018 Jan 23. Epub 2018 Jan 23.
    From the Departments of Emergency Medicine and Pediatrics, Children's Hospital of the King's Daughters, Norfolk, VA.
    Scurvy in modern times may not be as rare as previously thought. The link between adequate intake of vitamin C and scurvy has been known since ancient times and is recorded in Ebers Papyrus. Recent reports indicate that, with restricted diets, vitamin C deficiency is being seen in infants exclusively fed plant-based formula and children with oral aversion, autism, restricted diets, and cerebral palsy. Read More

    The Medicinal Usage and Restriction of Ginseng in Britain and America, 1660-1900.
    Uisahak 2017 Dec;26(3):503-544
    This article demonstrates the medicinal usage of ginseng in the West from 1660 to 1914. Asian[Korea] ginseng was first introduced into England in the early 17th century, and North American ginseng was found in the early 18th century. Starting from the late 17th century doctors prescribed ginseng to cure many different kinds of ailments and disease such as: fatigue general lethargy, fever, torpidity, trembling in the joints, nervous disorder, laughing and crying hysteria, scurvy, spermatic vessel infection, jaundice, leprosy, dry gripes and constipation, strangury, yellow fever, dysentery, infertility and addictions of alcohol, opium and tobacco, etc. Read More

    Scurvy: When it is a Forgotten Illness the Surgery Makes the Diagnosis.
    Open Orthop J 2017 20;11:1314-1320. Epub 2017 Nov 20.
    Department of Orthopedic Surgery and Traumatology, Hbib Bourguiba University Hospital Sfax, Tunisia.
    Background: Unlike most of animal species, human beings lack the enzymatic process for the conversion of glucose to ascorbic acid (vitaminC), and therefore getting the vitamin from food sources is essential. The association of the various signs caused by a deficiency of vitamin C is called scurvy or Barlow's disease, an easily treatable disease but can be fatal. It is rare in the developed countries and even economically underdeveloped societies in which the basic diet is already rich in ascorbate. Read More

    Paleopathological rigor and differential diagnosis: Case studies involving terminology, description, and diagnostic frameworks for scurvy in skeletal remains.
    Int J Paleopathol 2017 Dec 25;19:96-110. Epub 2015 Nov 25.
    Department of Sociology and Anthropology, George Mason University, United States; Museo Nacional Sicán, Peru; Museo Nacional de Arqueología y Etnografía Hans Heinrich Brüning de Lambayeque, Peru. Electronic address:
    Diverse pathological processes can produce overlapping or even indistinguishable patterns of abnormal bone formation or destruction, representing a fundamental challenge in the understanding of ancient diseases. This paper discusses increasing rigor in differential diagnosis through the paleopathological study of scurvy. First, paleopathology's use of descriptive terminology can strive to more thoroughly incorporate international standards of anatomical terminology. Read More

    Introduction: Scientific rigor in paleopathology.
    Int J Paleopathol 2017 Dec 13;19:80-87. Epub 2017 Oct 13.
    Arizona State University, United States.
    This introductory chapter to the Special Issue on "Scientific Rigor in Paleopathology" serves to orient and introduce the chapters that follow through a detailed consideration of paleopathology as a 21 century intellectual field. In this vein, we first make the significant point that paleopathology is a profoundly interdisciplinary endeavor, encompassing aspects of the biomedical science, the humanities, and the social sciences. Thus, we suggest that no one practitioner can personally command the range of skills necessary for a 21 century paleopathologist. Read More

    Nutrition for oral health and oral manifestations of poor nutrition and unhealthy habits.
    Gen Dent 2017 Nov-Dec;65(6):36-43
    The availability of proper nutrients is critical for the growth, development, maintenance, and repair of healthy dentition and oral tissues. Deficiencies particularly relevant to the dental practice are those in folate and other B complex vitamins; vitamins A, C, and D; calcium; fluoride; and protein. A lack of these nutrients affects nearly every structure in the oral cavity, causing or contributing to scurvy, cleft palate, enamel hypoplasia, poor mineralization, caries, and other pathoses. Read More

    The role of vitamin C in epigenetic regulation.
    Postepy Hig Med Dosw (Online) 2017 Aug;71(1):747-760
    Katedra Biochemii Klinicznej, Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu.
    Vitamin C (L-ascorbic acid) is a micronutrient best known for its anti-scurvy activity in humans. Vitamin C is involved in many biological processes involving enzymatic reactions that are catalyzed by members of dioxygenases which use Fe(II) and 2-oxoglutarate as a co-substrate.The article reviews recent data that suggest the involvement of ascorbate in dioxygenases catalyzed chromatin and DNA modifications which thereby contribute to epigenetic regulation. Read More

    Basilar portion porosity: A pathological lesion possibly associated with infantile scurvy.
    Int J Paleopathol 2017 Sep 16;18:92-97. Epub 2017 Jun 16.
    Archaeological Sciences, University of Bradford, Bradford, West Yorkshire, BD7 1DP, UK. Electronic address:
    Recent analysis of the juvenile (≤12 years) human remains from a 19th century site in Wolverhampton, England revealed a relatively high level of nutritional deficiency diseases within the population. Indeed, 41.7% of the 48 juvenile skeletons analysed exhibited a combination of porous and proliferative bone lesions consistent with the pathological alterations associated with nutritional stress. Read More

    Scurvy at the agricultural transition in the Atacama desert (ca 3600-3200 BP): nutritional stress at the maternal-foetal interface?
    Int J Paleopathol 2017 Sep 23;18:108-120. Epub 2017 Jun 23.
    Universidad de Tarapacá, Instituto de Alta Investigación, Chile.
    Studies of contemporary populations have demonstrated an association between decreased dietary diversity due to resource scarcity or underutilization and an increase in diseases related to poor micronutrient intake. With a reduction of dietary diversity, it is often the women and children in a population who are the first to suffer the effects of poor micronutrient status. Scurvy, a disease of prolonged vitamin C deficiency, is a micronutrient malnutrition disorder associated with resource scarcity, low dietary diversity, and/or dependence on high carbohydrate staple-foods. Read More

    Development and implementation of an HPLC-ECD method for analysis of vitamin C in plasma using single column and automatic alternating dual column regeneration.
    Pract Lab Med 2016 Dec 4;6:25-37. Epub 2016 Sep 4.
    Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, UT 84112, United States.
    Objectives: Vitamin C (l-ascorbic acid) is a water-soluble micronutrient necessary for human life. Inadequate intake can lead to the fatal disease scurvy. Measurement of vitamin C is used to assess nutritional status and to monitor supplementation. Read More

    Bateman purpura (dermatoporosis): a localized scurvy treated by topical vitamin C - double-blind randomized placebo-controlled clinical trial.
    J Eur Acad Dermatol Venereol 2018 Feb 5;32(2):323-328. Epub 2017 Sep 5.
    Laboratory of Skin Bioengineering and Imaging (LABIC), Department of Clinical Sciences, University of Liège, Liège, Belgium.
    Background: Bateman purpura is characterized by diffuse senile skin atrophy, senile purpura and spontaneous stellar pseudocicatrices. Cutaneous changes in the course of ageing have been related to lower levels of ascorbic acid into the dermis of elderly people.

    Objective: In this study, we postulate that senile purpura could be linked to dermal vitamin C deficiency and could be corrected by topical administration of this vitamin. Read More

    Plasma concentrations of ascorbic acid in a cross section of the German population.
    J Int Med Res 2018 Jan 31;46(1):168-174. Epub 2017 Jul 31.
    1 Department of Medicine 1, University of Erlangen - Nuremberg, Germany.
    Objectives Vitamin C deficiency is considered extremely rare in modern industrialized countries. This study was performed to assess vitamin C concentrations in the German population. Methods As part of a consultant-patient seminar on nutrition and food intolerances, patients were asked to participate in this study on a voluntary basis. Read More

    New evidence suggesting a dissociated etiology for cribra orbitalia and porotic hyperostosis.
    Am J Phys Anthropol 2017 09 8;164(1):76-96. Epub 2017 Jun 8.
    Department of Archaeology & Anthropology, Leverhulme Centre for Human Evolutionary Studies, University of Cambridge, United Kingdom.
    Objectives: Porotic hyperostosis (PH), characterized by porotic lesions on the cranial vault, and cribra orbitalia (CO), a localized appearance of porotic lesions on the roof of the orbits, are relatively common osteological conditions. Their etiology has been the focus of several studies, and an association with anemia has long been suggested. Anemia often causes bone marrow hypertrophy or hyperplasia, leading to the expansion in trabecular or cranial diploic bone as a result of increased hematopoiesis. Read More

    Health research and safeguards: The South African journey.
    S Afr Med J 2017 Apr 25;107(5):379-380. Epub 2017 Apr 25.
    Steve Biko Centre for Bioethics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
    Health research, as a social good, needs to be conducted in the interests of the common good. Because of the unfortunate exploitation of research participants globally, safeguards for protections are necessary. Most international codes and guidelines originated as responses to the abuse and mistreatment of research subjects. Read More

    The role of vitamin C in the treatment of pain: new insights.
    J Transl Med 2017 Apr 14;15(1):77. Epub 2017 Apr 14.
    Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, PO Box 4345, Christchurch, 8140, New Zealand.
    The vitamin C deficiency disease scurvy is characterised by musculoskeletal pain and recent epidemiological evidence has indicated an association between suboptimal vitamin C status and spinal pain. Furthermore, accumulating evidence indicates that vitamin C administration can exhibit analgesic properties in some clinical conditions. The prevalence of hypovitaminosis C and vitamin C deficiency is high in various patient groups, such as surgical/trauma, infectious diseases and cancer patients. Read More

    Gingival bleeding in a patient with autism spectrum disorder: A key finding leading to a diagnosis of scurvy.
    Quintessence Int 2017 ;48(5):407-411
    Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that can affect all aspects of life, including nutrition. This case reports a patient with ASD in which gingival bleeding was the key finding that led to a diagnosis of scurvy. The literature review discusses behavioral food aversions in patients with ASD that lead to significant nutritional deficiencies, such as scurvy. Read More

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