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J Pediatr Gastroenterol Nutr 2020 May 26. Epub 2020 May 26.

Associate Professor, Division of Gastroenterology and Nutrition, Department of Pediatrics, University of Alberta, Alberta, Edmonton, Canada, Potential Conflict of Interest, Research funding from VectiveBio AG, for the NASPGHAN Committee on Nutrition.

Parents and caretakers are increasingly feeding infants and young children plant-based "milk" alternatives to cow milk. The US Food and Drug Administration currently defines "milk" and related milk products by the product source and the inherent nutrients provided by bovine milk. Substitution of a milk that does not provide a similar nutritional profile to cow milk can be deleterious to a child's nutritional status, growth and development. Read More

Int J Surg Case Rep 2020 May 21;71:126-127. Epub 2020 May 21.

University of Florida, Division of General Internal Medicine, 2000 SW Archer Rd., Gainesville, FL 32608, United States. Electronic address:

J Am Coll Health 2020 May 20:1-3. Epub 2020 May 20.

Health Services, Brown University, Providence, Rhode Island, USA.

A previously healthy university student presents to Health Services with sudden onset of pain, fatigue, bruising, and a rapidly progressive anemia. There was not any previous significant health history. The case discussion will emphasize the critical overlap of physical and mental health assessments in identifying the cause and cure of a potentially life-threatening health crisis for a young adult student. Read More

N Engl J Med 2020 May;382(20):e56

University of Arkansas for Medical Sciences, Little Rock, AR

Am J Surg 2020 May 5. Epub 2020 May 5.

Duke University Department of Surgery, DUMC 3704, Durham, NC, 27710, USA. Electronic address:

COVID-19 has sickened millions, killed hundreds of thousands, and disrupted daily life for citizens around the world. Utterly devastating, COVID-19 is but the most recent pandemic to sweep the globe. Throughout history, surgeons like Guy de Chauliac, James Lind, John Hunter, John Snow, and Walter Reed have led scientific campaigns to understand, prevent, and treat epidemics like the bubonic plague, scurvy, syphilis, cholera, and yellow fever. Read More

Nutrients 2020 May 6;12(5). Epub 2020 May 6.

The Infection Group, Department of Pathology and Biomedical Science, University of Otago, Christchurch 8011, New Zealand.

Pneumonia is a severe lower respiratory tract infection that is a common complication and a major cause of mortality of the vitamin C-deficiency disease scurvy. This suggests an important link between vitamin C status and lower respiratory tract infections. Due to the paucity of information on the vitamin C status of patients with pneumonia, we assessed the vitamin C status of 50 patients with community-acquired pneumonia and compared these with 50 healthy community controls. Read More

J Sep Sci 2020 May 8. Epub 2020 May 8.

Unité de Technologies Chimiques et Biologiques pour la Santé (UTCBS), Faculté de sciences pharmaceutiques et biologiques, Université de Paris, Paris, France.

Ascorbic acid is a powerful antioxidant compound involved in many biological functions, and a chronic deficiency is at the origin of scurvy disease. A simple, rapid, and cost-effective capillary electrophoresis method was developed for the separation and simultaneous quantification of ascorbic acid and the major degradation products: dehydroascorbic acid, furfural, and furoic acid. Systematic optimization of the conditions was performed that enabled baseline separation of the compounds in less than 10 min. Read More

Cutis 2020 03;105(3):146-147;149

Department of Dermatology, Weill Cornell Medicine, New York, New York, USA.

Beau lines, onychomadesis, and retronychia are nail conditions with their own characteristic clinical findings. It has been hypothesized that these 3 disorders may share a common pathophysiologic mechanism of slowing and/or halting nail plate production at the nail matrix. We report the case of a 41-year-old woman who presented with concurrent Beau lines, onychomadesis, and retronychia 6 months following a diagnosis of scurvy. Read More

Spec Care Dentist 2020 May 24;40(3):251-259. Epub 2020 Apr 24.

Department of Pediatric Dentistry, The University of Texas Health Science Center at Houston, School of Dentistry, Houston, Texas, USA.

Background: Scurvy, the disease resulting from vitamin C deficiency, is perceived as being rare and occurring predominantly in the past. However, scurvy continues to exist and may be encountered in children with medical/developmental conditions and/or restricted diet. Diagnosis can be challenging given the perceived rarity of the condition and nonspecific symptoms, including gingival disease. Read More

Case Rep Med 2020 9;2020:4798941. Epub 2020 Apr 9.

Florida International University, Miami, FL, USA.

We report a case of myopathy in a chronic alcoholic patient with scurvy who presented with generalized weakness, myalgias, and arthralgia. Our case raises awareness regarding rare interaction between vitamin C deficiency and myopathy which is seen more commonly in patients with history of chronic alcoholism and low socioeconomic status. Early treatment with vitamin C replacement is helpful in treatment of the disease and its complications. Read More

Spectrochim Acta A Mol Biomol Spectrosc 2020 Aug 13;236:118356. Epub 2020 Apr 13.

School of Chemistry, Nanchang University, Nanchang 330031, China.

Foods generally contain special ingredients which easily to interact with drugs human intaking, thus affecting drug efficacy and excretion, and even cause adverse reactions. Vitamin C (Vit. C) is abundant in fresh fruits and vegetables. Read More

Eur J Clin Nutr 2020 Apr 20. Epub 2020 Apr 20.

Institut d'Hématologie et Oncologie Pédiatrique, Lyon, France.

We report the case of a 14-year-old boy with a completely normal medical and social background (good student and handball practice). A dentist monthly followed this patient for an orthodontic treatment. Facing with symptoms associating purpura, pancytopenia, and limbs pain, the first diagnosis that came to mind to emergency pediatricians was acute leukemia and the patient was addressed to a hematology department. Read More

J Adolesc Health 2020 Apr 11. Epub 2020 Apr 11.

Division of Adolescent Medicine, Department of Pediatrics, Hospital for Sick Children, Toronto, Canada; University of Toronto, Toronto, Canada; Research Institute, Hospital for Sick Children, Toronto, Canada. Electronic address:

Vitamin C deficiency results in the clinical presentation of scurvy, a disease that is rare among the adolescent population. Individuals with unusual dietary habits, mental illness, or physical disability are more prone to develop scurvy. We present a case report of a previously healthy 16-year-old female presented to the hospital with a 12-month history of anorexia nervosa, restrictive subtype. Read More

Intern Med J 2020 Apr;50(4):495-498

Sydney, New South Wales, Australia.

The 250-year anniversary of Cook's landfall at Botany Bay on 28 April 1770, approximately half way through a global circumnavigation, was an extraordinary maritime undertaking. An enterprise of astronomy, cartography, cultural-botanical documentation and revelation achieved without a death from infectious disease and only 10 mild cases of scurvy in a ship's company of 95 men. The subsequent homeward journey was far less endurable, marked by shipwreck, unforeseen prolonged delays and fatal epidemics of flux and malaria. Read More

Nutrition 2020 Jan 30;75-76:110726. Epub 2020 Jan 30.

University Hospital Bonn, Department of Orthopedics and traumatology, Bonn, Germany.

Objective: Infantile scurvy or Moller-Barlow's disease appears to be of no further importance in Western countries; however, this is a careless assumption. In severely disabled children especially, this malady manifests itself in a broad range of symptoms such as delayed or suppressed bone healing, minor traumatization leading to bruises or fractures, and epiphysiolysis.

Methods: The aim of this article was to present the required daily uptake of vitamin C and the biochemical pathways in the human body leading to the typical symptoms of scurvy. Read More

Oral Health Prev Dent 2020 ;18(2):115-124

In humans, ascorbic acid, better known as vitamin C, is a true vitamin because humans lack the ability to synthesise it. Vitamin C exhibits a number of enzymatic and non-enzymatic effects but all are accounted for by the ability of vitamin C to donate electrons and therefore acts as a reducing agent. It has a wide range of functions. Read More

Int J Surg Case Rep 2020 7;68:263-266. Epub 2020 Mar 7.

Department of Orthopaedic - Traumatology, Faculty of Medicine Universitas, Indonesia.

Introduction: Scurvy is a rare condition in pediatric patients, resulted from a vitamin C deficiency. Musculoskeletal symptoms occur in 80% of patient. The rarity and the polymorphisms of the clinical signs and symptoms often make scurvy an unknown or forgotten diagnosis. Read More

Int J Dermatol 2020 Mar 10. Epub 2020 Mar 10.

Departments of Dermatology and Pathology, Wayne State University School of Medicine, Detroit, Michigan, USA.

Scurvy is a nutritional disorder resulting from vitamin C deficiency. Although rare in developing countries, scurvy continues to develop in settings of limited dietary intake such as post-gastrointestinal surgery and restrictive dietary habits. The disease primarily affects the skin and soft tissue. Read More

Arch Dis Child Educ Pract Ed 2020 Mar 8. Epub 2020 Mar 8.

Department of Paediatrics, Lister Hospital, Stevenage, UK.

A 12-year-old boy was admitted to the paediatric ward with a 4-month history of worsening pain and bruising to his legs, which had resulted in a progressive reduction in his mobility. He initially had had difficulty weight bearing, which had then progressed further making him wheelchair bound. On examination, there was extensive bruising (figure 1) to his oedematous legs, worse on his right leg compared with his left. Read More

Intern Med J 2020 Mar;50(3):378-380

Medical Historian, Sydney, New South Wales, Australia.

The east coast of New Holland was discovered 250 years ago during a voyage of covert strategic exploration of the Pacific Ocean regions by Lieutenant James Cook acting under instructions of the Royal Navy espionage chief, Philip Stephens, Secretary of the Admiralty. In addition to the study of the transit of Venus, the well resourced mission included some clandestine mapmaking during August 1768 to July 1771. Tasked by the Royal Society of London to investigate the anti-scorbutic effects of a variety of foods and herbs, Cook's post-operational debrief to the Admiralty included the inaccurate supposition that HM Bark Endeavour's cruise was scurvy-free. Read More

BMJ Case Rep 2020 Mar 4;13(3). Epub 2020 Mar 4.

Department of General Medicine, Monash Health, Clayton, Victoria, Australia.

A 66-year-old Caucasian woman was admitted with deteriorating mental health in the setting of background history of schizophrenia and depression. Her husband reported that she had increasing negative thoughts and decreased motivation regarding her self-care over a few weeks with no obvious stressors. Initial laboratory tests were unremarkable except for isolated normocytic anaemia. Read More

Eur J Case Rep Intern Med 2020 10;7(2):001404. Epub 2020 Jan 10.

Internal Medicine Service, Federal University of Pernambuco, Recife, Brazil.

Pulmonary hypertension (PH) can be related to several diseases, such as connective tissue disorders and pulmonary embolism, or to drugs; it may also be idiopathic. Few cases have been reported demonstrating an association between ascorbic acid deficiency and reversible PH. We report the case of a patient who arrived at the emergency department with dyspnoea, tachycardia and lower limb perifollicular haemorrhage. Read More

J Pediatr 2020 Mar;218:1-4

Front Pediatr 2020 31;8. Epub 2020 Jan 31.

General Pediatrics Department, Necker Hospital, Paris, France.

We report 3 cases of scurvy in children that occurred during a short period (2018) in a general pediatrics unit of a tertiary hospital for children in Paris. All children were around 3 years of age and were admitted for skeletal pain and altered general state, which mimicked infectious or malignant diseases. Their selective diet was not the prominent issue. Read More

J Dev Behav Pediatr 2020 Feb 10. Epub 2020 Feb 10.

Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.

Objective: To document the clinical presentation of scurvy in children with autism spectrum disorder (ASD) and summarize the contemporary approaches to assessment and management in this population. Scurvy is a disease caused by vitamin C deficiency most often detected in populations at high risk for nutrition insufficiency (e.g. Read More

3 Biotech 2020 Feb 16;10(2):50. Epub 2020 Jan 16.

Department of Spine Surgery, Tianjin Hospital, Tianjin, 300211 China.

Spinal cord injury (SCI) results in severe damage, which causes functional alterations together with loss of autonomic functions, sensations, and muscle functioning. This injury leads to apoptosis of neurons and oligodendrocytes, which further leads to dysfunction of the spinal cord due to axonal degeneration and demyelination. Taurine is non-proteogenic and an essential amino acid, which plays a major role in the growth and development of brain cells. Read More

CMAJ 2020 Jan;192(4):E96

Department of Medicine (Colacci, Gold, Shah), University of Toronto; Divisions of Infectious Diseases (Gold) and General Internal Medicine (Gold, Shah), University Health Network, Toronto, Ont.

J Med Case Rep 2020 Jan 24;14(1):18. Epub 2020 Jan 24.

Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Via Consolare Valeria 1, 98124, Messina, Italy.

Background: Since ancient times, scurvy has been considered one of the most fearsome nutritional deficiency diseases. In modern developed countries, this condition has become very rare and is only occasionally encountered, especially in the pediatric population. Underlying medical conditions, such as neuropsychiatric disorders, anorexia nervosa, celiac disease, Crohn disease, hemodialysis, and severe allergies to food products may enhance the risk of developing scurvy. Read More

Nutrients 2020 Jan 16;12(1). Epub 2020 Jan 16.

Bayer Consumer Care AG, 4002 Basel, Switzerland.

Immune support by micronutrients is historically based on vitamin C deficiency and supplementation in scurvy in early times. It has since been established that the complex, integrated immune system needs multiple specific micronutrients, including vitamins A, D, C, E, B6, and B12, folate, zinc, iron, copper, and selenium, which play vital, often synergistic roles at every stage of the immune response. Adequate amounts are essential to ensure the proper function of physical barriers and immune cells; however, daily micronutrient intakes necessary to support immune function may be higher than current recommended dietary allowances. Read More

J Gen Intern Med 2020 Jan 15. Epub 2020 Jan 15.

Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Monogr Oral Sci 2020 7;28:59-67. Epub 2019 Nov 7.

Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, USA.

Vitamins are essential organic compounds that catalyze metabolic reactions. They also function as electron donors, antioxidants or transcription effectors. They can be extracted from food and supplements, or in some cases, synthesized by our body or gut microbiome. Read More

Nutrients 2020 Jan 7;12(1). Epub 2020 Jan 7.

Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain.

Pulmonary arterial hypertension (PAH) is characterized by sustained vasoconstriction, vascular remodeling, inflammation, and in situ thrombosis. Although there have been important advances in the knowledge of the pathophysiology of PAH, it remains a debilitating, limiting, and rapidly progressive disease. Vitamin D and iron deficiency are worldwide health problems of pandemic proportions. Read More

Internist (Berl) 2020 Feb;61(2):213-216

Schön Klinik Hamburg Eilbek, Dehnhaide 120, 22081, Hamburg, Deutschland.

A female patient presented with exertional dyspnea, myalgia, a petechial rash of the lower extremities and pronounced gingivitis. The biochemical test results showed the presence of anemia. The patient had a known eating disorder and on questioning about eating habits admitted that she did not eat any fruit or vegetables. Read More

J Stomatol Oral Maxillofac Surg 2020 Apr 2;121(2):192-194. Epub 2020 Jan 2.

Department of Anatomy, University of Otago, 270 Great King Street, Dunedin, 9016 Otago, New Zealand.

J Stomatol Oral Maxillofac Surg 2020 Apr 2;121(2):194-197. Epub 2020 Jan 2.

Legal Medicine Section, Department of Public Health and Pediatric Sciences, University of Turin, Italy; Warwick Medical School, Biomedical Sciences, The University of Warwick, Coventry, United Kingdom; Faculté de Médecine de Marseille, UMR 7268, Laboratore d'Anthropologie bio-culturelle, Droit, Ethique & Santé (Adés), France.

Osteoporos Int 2020 May 4;31(5):1001-1005. Epub 2020 Jan 4.

Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY, USA.

Purpose: Scurvy, due to vitamin C deficiency, is commonly referenced as a "forgotten" or "historical" disease. A growing number of case reports challenge this notion. Bone health providers are often consulted early in the presentation of scurvy to evaluate musculoskeletal complaints resulting from impaired collagen production and disrupted endochondral bone formation. Read More

Rev Med Interne 2020 May 24;41(5):339-342. Epub 2019 Dec 24.

Vascular hemostasis unit, Normandie Univ, UNIROUEN, Inserm U1096, Rouen university hospital, 76000 Rouen, France.

Introduction: Hemolacria is a rare hemorrhagic syndrome characterized by bloody tears. The most common etiologies are inflammation, infection or laceration. However, other rarer diseases may also cause this clinical manifestation. Read More

J Clin Rheumatol 2019 Dec 21. Epub 2019 Dec 21.

From the Department of Rheumatology, Frimley Park Hospital, Frimley, Camberley, United Kingdom.

Antioxid Redox Signal 2020 Jan 22. Epub 2020 Jan 22.

Istituto di Ricerche Farmacologiche Mario Negri-IRCCS, Milan, Italy.

Humans cannot synthesize ascorbic acid (AscH) (vitamin C), so deficiencies in dietary AscH cause the life-threatening disease of scurvy and many other diseases. After oral ingestion, plasma AscH concentrations are strictly controlled by transporters, which are required for entry into the cell and into intracellular organelles. Besides its general antioxidant function, AscH is a cofactor for endoplasmic reticulum (ER)-localized collagen hydroxylases. Read More

Blood 2019 12;134(25):2330

Children's Hospital of Philadelphia.

A A Pract 2020 Jan;14(1):15-17

From the Department of Anesthesia, Cook Children's Medical Center, Fort Worth, Texas.

Autism spectrum disorder (ASD) may be associated with self-imposed dietary restrictions causing nutritional deficiencies, and the anesthesiologist must be aware of their potential clinical implications. Because humans are unable to produce ascorbic acid through endogenous metabolic pathways and children with ASD may avoid vitamin C-containing foods, vitamin C deficiency, or scurvy, may develop in patients scheduled for general anesthesia. Vitamin C deficiency may cause dysfunction in autonomic nervous system processes or pulmonary hypertension resulting in unexpected hemodynamic lability. Read More

J Pediatr 2020 Mar 13;218:234-237.e2. Epub 2019 Dec 13.

Department of Pediatric Rheumatology, Seattle Children's Hospital and Research Center, Seattle, WA. Electronic address:

Ten patients with scurvy were evaluated by rheumatology; we review their clinical, laboratory, and dietary presentations. Eight patients had developmental delay or autism. All had elevated inflammatory markers. Read More

Mayo Clin Proc 2019 12;94(12):2594-2597

Department of Medicine, Faculty of Medicine and Health, The University of Sydney, Nepean Hospital, Kingswood, Australia.

Rev Med Suisse 2019 Nov;15(672):2125-2130

Service de médecine interne, Département de médecine, CHUV, 1011 Lausanne.

In elderly or chronically ill patients, nutritional deficiencies are common and the presence of related skin lesions is not unusual. Recognition of such cutaneous involvement is important regarding the diagnosis essentially based on clinical elements. By using some clinical case reports, we will describe several pathologies related to nutritional deficiencies like scurvy, pellagra and acquired acrodermatitis enteropathica. Read More

Med Hypotheses 2020 Feb 23;135:109448. Epub 2019 Oct 23.

The Third Hospital of Wuhan City, Wuhan, China. Electronic address:

Vitamins are indispensable nutrients for metabolism. Adequate vitamin intake plays vital role in physiological processes including embryonic development, cellular and immunity proliferation and differentiation, DNA synthesis and oxidative response. In contrast, insufficient vitamin levels usually lead to a large number of clinical manifestations including xerophthalmia, nyctalopia, hyperpigmentation, vitiligo, jaundice, megaloblastic anemia, glossitis, scurvy, stroke, cancer, coronary heart disease, Alzheimer's disease, multiple sclerosis and Parkinson's disease. Read More

Clin Med (Lond) 2019 Nov;19(6):526-527

Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK

Cureus 2019 Sep 18;11(9):e5694. Epub 2019 Sep 18.

Hematology and Oncology, Cleveland Clinic - Fairview Hospital, Cleveland, USA.

Scurvy is a rather uncommon disease today, and its symptoms can certainly be exhibited with vitamin C deficiency. Dangerously low levels of the vitamin can cause serious health complications and have been proven to be fatal. We present the case of a 42-year-old female with multiple primary diagnoses: easy bruising and Raynaud's syndrome without gangrene. Read More

Cureus 2019 Sep 9;11(9):e5608. Epub 2019 Sep 9.

Pediatrics, Nihon Uniiversity School of Medicine, Tokyo, JPN.

So far, little attention has been paid to the increase in acute phase reactants (APRs) in patients with scurvy. We report that elevated levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and serum amyloid A were shown in a pediatric patient with scurvy despite the absence of inflammation. These peculiar findings are important to discriminate scurvy from other rheumatic diseases. Read More

Eur J Microbiol Immunol (Bp) 2019 Oct 16;9(3):73-79. Epub 2019 Aug 16.

Institute of Microbiology, Infectious Diseases and Immunology, Gastrointestinal Microbiology Research Group, Charité - University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

Humans have lost their vitamin C-synthesizing capacities during evolution. Therefore, the uptake of this essential compound from external sources is mandatory in order to prevent vitamin C-deficient conditions resulting in severe morbidities such as scurvy. The potent antioxidant, immunomodulatory, and antiinfectious effects of vitamin C are known since the 1930s. Read More