Vitamin C Deficiency of Korean Homeless Patients Visiting to Emergency Department with Acute Alcohol Intoxication

Vitamins are essential micronutrients for maintenance of tissue functions. Vitamin deficiency is one of the most serious and common health problems among both chronic alcoholics and the homeless. However, the vitamin-level statuses of such people have been little studied. We evaluated the actual vitamin statuses of alcoholic homeless patients who visited an emergency department (ED). In this study the blood levels of vitamins B1, B12, B6, and C of 217 alcoholic homeless patients were evaluated retrospectively in a single urban teaching hospital ED. Vitamin C deficiency was observed in 84.3% of the patients. The vitamin B1, B12, and B6 deficiency rates, meanwhile, were 2.3%, 2.3%, and 23.5%, respectively. Comparing the admitted patients with those who were discharged, only the vitamin C level was lower. (P=0.003) In fact, the patients' vitamin C levels were markedly diminished, vitamin C replacement therapy for homeless patients should be considered in EDs.

Rare Case of Scorbutic Gingivitis.

Scorbutic Gingivitis was a condition of great prevalence among sailors of the yesteryears. With added advancement and diet consciousness the condition is a rarity now. Although scurvy is prevalent in population below poverty line, in this patient having scorbutic gingivitis, it was ironic that the patient starved due to religious belief and not due to circumstances. Vitamin C is the vitamin with the second largest daily requirement and plays a vital role in a host of metabolic reactions. Its lack produces a panorama of signs and symptoms, many of which present primarily or originally in the mouth. This case report of a rare case of Scorbutic gingivitis was diagnosed and treated in Department of Periodontology and reviews the case itself and the recent literature on this potentially fatal condition.

Scurvy

Scurvy is a condition caused by a lack of vitamin C [ascorbic acid] in the diet. It is extremely rare in industrialized societies but still exists in higher risk groups including economically disadvantaged populations with poor nutrition. We are reporting a case of 4 year old Asad who presented to our department with this condition

Perifollicular hemorrhagic lesions and broken twisted hairs on legs

A 17-year-old girl presented with multiple perifollicular hemorrhagic lesions on legs for 2 weeks. There was history of intermittent gum bleeding for last 2 months. Clinical examination revealed follicular keratosis and broken twisted hair [corkscrew hair], in addition to hemorrhagic lesions. Perifollicular hemorrhagic lesions and corkscrew hair are virtually pathognomonic for scurvy. When specifically asked, mother revealed that the girl was on self-imposed diet with almost no citrus fruits. Based on history and clinical findings, diagnosis of scurvy was made. The response to vitamin C supplementation was very good and all the lesions disappeared within one month. Scurvy has been reported in increasing numbers in recent literature; hence, recognition of scurvy is essential to avoid many serious complications including internal bleeding and even, death

Escorbuto / Scurvy

Apesar de considerado raro, o escorbuto, doença clínica causada pela deficiência de vitamina C, ainda ocorre nos dias de hoje, inclusive em países desenvolvidos. É caracterizada por acometer pacientes com história de alcoolismo, baixo nível socioeconômico, alergia alimentar e doenças psiquiátricas. A causa principal é a insuficiente ingestão de frutas e vegetais frescos. A apresentação clínica consiste de sinais e sintomas inespecíficos. Essas manifestações podem estar associadas ao acometimento de diversos órgãos, como a pele e os sistemas hematológico, articular e ósseo, pois o ácido ascórbico constitui elemento fundamental na formação do componente essencial desses tecidos: o colágeno. O diagnóstico é essencialmente clínico, baseando-se na sintomatologia e história dietética do paciente. O tratamento é feito com reposição de vitamina C em doses que variam de 500mg a 1g por dia, com resultados satisfatórios em curto espaço de tempo. Descrevemos o caso de uma paciente com 24 anos, com manifestações típicas de deficiência de vitamina C, retratando uma apresentação clássica de escorbuto nos dias atuais

Although considered rare, scurvy, a clinical disease caused by deficiency of vitamin C, still occurs today, even in developed countries. It usually affects patients with a history of alcohol abuse, low socio-economic status, food allergy and psychiatric disorders. The main cause is insufficient intake of fresh fruit and vegetables. The clinical presentation consists of nonspecific signs and symptoms. These symptoms may be associated with the involvement of various organs such as the skin and the hematological, joint and bone systems, because ascorbic acid is a crucial element in the formation of collagen, the essential component of these tissues. The diagnosis is essentially clinical, based on symptoms and dietary history of the patient. Treatment is with supplements of vitamin C in doses ranging from 500mg to 1g per day, with satisfactory results in a short time. We report the case of a 24-year female patient with typical manifestations of vitamin C deficiency, featuring a typical presentation of scurvy today

Inability to walk due to scurvy: a forgotten disease

Scurvy has become rare in modern societies, but should be considered in malnourished persons, alcoholics, and in infants on unsupplemented milk diets who present with musculoskeletal pain or a bleeding tendency. The diagnosis of scurvy can be challenging because of the rare incidence and vague and nonspecific early symptoms. We report here a case of scurvy in a young boy who presented with an inability to walk and severe musculoskeletal pain. The diagnosis was established based on his clinical picture, radiological appearance, and low serum level of vitamin C. The patient responded well to vitamin C supplementation with full resolution of his symptoms. He regained his ability to walk and his family was happy and satisfied with the outcome of treatment. Although the incidence of scurvy has become low in Saudi Arabia, it can still occur and early recognition is important because of the excellent prognosis

Scurvy: presenting as musculoskeletal pain

The incidence of scurvy in the paediatric population is very low. This report describes a case of scurvy in toddler girl who was admitted with severe pain in legs and difficulty in walking along with bleeding from gums. After extensive investigation, she was found to have vitamin C deficiency resulting from restrictive eating pattern. There was significant improvement in presenting symptoms and general health after introduction of vitamin C and fresh fruits and vegetables to her diet. Nutrition-based diseases can still occur in any socioeconomic setting. Nutritional screening remains an important part in every child's general health care

Scurvy in infantile tremor syndrome.

Infantile Tremor Syndrome is a distinct clinical entity most commonly seen in Indian Subcontinent. Syndrome consists of tremors, mental and developmental retardation, abnormal skin pigmentation and anemia in children between 6 months to 2 years. The etiology is still elusive. Amongst various theories, nutritional theory is the most accepted. So far there are no cases reported of vitamin C deficiency in ITS. In this article, three cases of ITS associated with vitamin C deficiency are reported.

Central retinal vein thrombosis as an initial manifestation of heterozygous protein C deficiency: case report

The purpose of this paper is to report a case of central retinal vein thrombosis associated with isolated heterozygous protein C deficiency. Acute oclusion of the central retinal vein presents as one of the most dramatic pictures in ophthalmology. It is often a result of both local and systemic causes. A rare systemic cause is heterozygous protein C deficiency, and it usually occurs in combination with other thrombophilic conditions. This case highlights that isolated heterozygous protein Cdeficiency may be the cause of central retinal vein thrombosis and underscores the importance of its screening in yong patients with this ophthalmologic disease.

Factores condicionantes, base para la salud bucal / Conditioning factors, basis for oral health

Se detallan signos y síntomas de cuadros subclínicos de deficienias nutricionales, en pacientes atendidos en consultorios odontológicos. Descubrirlos a tiempo, permite efectuar acciones de protección y prevención de la salud, induciendo cambios en su alimentación. Lo importante es mejorar el nivel de vida, modificando de a poco, gradualmente, los malos hábitos higiénico dietéticos individuales para acostumbrarse a una alimentación variada y equilibrada, comiendo de todo moderadamente, evitando así los excesos

Factores dietéticos y ruptura prematura de membranas: efecto de la vitamina C en la degradación de colágena en el corioamnios / Dietetic factors and premature membranes rupture: vitamin C effect on collagen degradation at amniochorion

Diferentes estudios han mostrado asociación entre la disponibilidad de vitamina C ( vit C) y el desarrollo de ruptura prematura de membranas (RPM). Sin embargo, no ha analizado el papel que desempeña la vit C en el metabolismo de la colágena en el tejido corioamniótico. En este trabajo se analizó el efecto de modulación de diferentes concentraciones de vit C en células en cultivo derivativas de amnios humano. Se utilizaron concentraciones de vit C de manera de cubrir el rango fisiológico (29.0 µg/mL). Luego de ser estimuladas, los medios de las células fueron analizados para actividad enzimática de metaloproteasas de matriz extracelular (MMP) y se cuantificó la cantidad relativa de MMP-1, MMP-2 y MMP-9 mediante inmunotransferencia, utilizando anticuerpos policlonales monoespecíficos. Tanto la actividad como la proteína en los medios de las células amnióticas, disminuyó de manera directa a la concentración de vit C, de manera que a las concentraciones más altas probadas (100 µg/mL) se obtuvo la menor actividad/cantidad de MMP. Los resultados anteriores aportan un dato hasta ahora no descrito y que permite establecer una conexión directa entre la disponibilidad de vitamina C y el aumento en la degradación de colágeno. De acuerdo a los resultados, a menor disponibilidad de vit C, mayor degradación de colágena, que debería llevar a pérdida de soporte mecánico y eventual ruptura de las membranas fetales

Study of ascorbic acid in rachitic infants

Serum ascorbic acid and urinary excretion of hydroxyproline were investigated in 25 Egyptian rachitic infants and 15 healthy control infants. Significant decline [P < 0.001] was observed in serum ascorbic acid of rachitic infants as compared to controls. It appears that ascorbic acid may be one of the causes of nutritional rickets in Egypt, and ascorbic acid deficiency augments the manifestations of vitamin D depletion. Supplementation of infants by ascorbic acid drugs at least during the first two months of life has to be seriously considered. A significant increase in hydroxyproline/creatinine ratio was detected in rachitic infants, compared to control. The high urinary excretion of hydroxyproline in infants with rickets can be due to increased bone resorption that involves dissolution of both minerals and organic matrix which is rich in hydroxyproline containing collagen

Correlacao entre hipercolesterolemia e dieta deficiente em vitamina C / Correlation between hypercholesterolemia and vitamin C deficient diet

A carencia de vitamina C interfere tanto na atividade da enzima lecitina colesterol acil-transferase como na transformacao do colesterol em seu principal catabolico: os acidos biliares. Tem-se observado ainda, a presenca de varicosidade da veia sublingual em individuos com hipovitaminose C. Selecionamos quinze pacientes com niveis sanguineos de colesterol normais e quinze pacientes hipercolesterolemicos para estudar a correlacao entre a hipercolesterolemia e a deficiencia de ingestao de vitamina C. Realizamos analise estatistica com teste "t" de Student e teste tipo Caso-Controle, obtendo os seguintes dados: (1) Quanto ao nivel de colesterol, os dois grupos apresentaram diferenca significativa, no grupo hipercolesterolemicos com niveis de 422 ñ 116,2018 mg/100 ml e no grupo normocolesterolemicos 160,73 ñ 29,5356 mg/100 ml. (2) A media diaria de vitamina C na dieta e significativamente maior no grupo normocolesterolemico (170,33 ñ 75,18 mg) do que no grupo hipercolesterolemico (39,01 ñ 25,89 mg). (3) O grupo hipercolesterolemico apresenta uma media de ingestao diaria maior do colesterol do que o grupo normocolesterolemico, porem nao ha significancia estatistica. (4) O grupo hipercolesterolemico demonstra a ocorrencia maior de varicosidade sublingual estatisticamente significante em treze casos enquanto que no...