ICD-11

Scurvy is a disease caused by a lack of vitamin C (ascorbic acid) in the diet. Vitamin C plays a central role in collagen and ground-substance formation, metabolism of aromatic amino acids (phenylalanine, tyrosine), reduction of folic acid to folinic acid and a broad range of biochemical redox reactions. Clinical features include perifollicular haemorrhages, ecchymoses, swollen bleeding gums, stomatitis and epistaxis.

Scurvy is characterized by three important manifestations: gingival changes, pain in the extremities and haemorrhagic manifestations. It can be detected from early signs of clinical deficiency such as irritability, loss of appetite, follicular hyperkeratosis, petechial haemorrhages, swollen or bleeding gums, and joint pain, or from the very low concentrations of ascorbate in plasma, blood or leukocytes. Skeletal and vascular lesions related to scurvy probably arise from a failure of osteoid formation. In infantile scurvy the changes are mainly at the sites of most active bone growth; characteristic signs are a pseudoparalysis of the limbs caused by extreme pain on movement and caused by haemorrhages under the periosteum, as well as swelling and haemorrhages of the gums surrounding erupting teeth. A “rosary” at the costochondral junctions and depression of the sternum are other typical features. In adults, one of the early principle adverse effects of the collagen-related pathology may be impaired wound healing.