1
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Salimi Y, Tavahodi N, Taheri H, Masoudi M, Modaber MS, Azimi N, Amin MN, Bagharianlemraski M, Namadkolahi R, Khorami M, Salahi M, Razavi P, Behshood P, Mosaddad SA, Deravi N. Effect of Mangifera Indica (Mango) on Dental Caries: A Systematic Review. Nutr Metab Insights 2023; 16:11786388231204200. [PMID: 38024868 PMCID: PMC10657530 DOI: 10.1177/11786388231204200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 09/12/2023] [Indexed: 12/01/2023] Open
Abstract
The present study aimed to evaluate the effect of Mangifera indica (mango) on dental caries. The entire plant, including the leaves, fruit, roots, and flowers, has various therapeutic characteristics used for centuries to cure various illnesses. This systematic review aimed to identify an inexpensive, simple, and effective method of preventing and controlling dental caries. The search was performed among the studies written in English, the database of abstracts concentrating on the effects of Mangifera indica (Mango) on dental caries detected in Pubmed, Scopus, Google Scholar, and Central. In total, we find 37 articles. The relevant English language articles published up to August 2022 were collected, screened, and reviewed. Search words contained "Mangifera indica" and "dental caries" or "Streptococcus mutans" or "tooth demineralization." For our systematic review analysis, we included 3 randomized controlled trial studies studying a total of 130 people, of whom 110 were children aged 8 to 14 and 20 were adults aged 20 to 25. These experiments all employed mouthwash containing an extract from Mangifera indica. In conclusion, it has been proven in 2 separate studies that saliva's PH will increase significantly. In addition, a reduction of S. mutants has been observed in another research. Overall, it was concluded that mango extract mouthwash is highly effective in decreasing the bacteria that can cause dental caries. however, we firmly believe that conduction of more detailed in vivo studies regarding Mangifera indica implications in dental caries treatment is essentially needed for further confirmation.
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Affiliation(s)
- Yasaman Salimi
- Student Research Committee, Kermanshah University of Medical sciences, Kermanshah, Iran
| | - Narges Tavahodi
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamed Taheri
- Dental School, Kazan federal University, Kazan, Russian
| | - Maryam Masoudi
- Faculty of Pharmacy, Pharmaceutical Science Branch, Islamic Azad University, Tehran, Iran
| | - Matin Safari Modaber
- Student Research Committee, Faculty of Dentistry, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Nozhan Azimi
- Student Research Committee, Dental Branch, Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Mohammed Namiq Amin
- Student Research Committee, Kermanshah University of Medical sciences, Kermanshah, Iran
| | - Mobina Bagharianlemraski
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Namadkolahi
- Student Research Committee, Faculty of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mozhgan Khorami
- Faculty of dentistry, Mashhad University of Medical Sciences, Iran
| | - Mehrnaz Salahi
- Student Research Committee, School of Pharmacy and Pharmaceutical Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Pouyan Razavi
- Student Research Committee, Dental Branch, Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Parisa Behshood
- Ph.d Department of Microbiology, Young Researchers and Alite Club, Isalamic Azad University, Shahrekord, Iran
| | - Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Niloofar Deravi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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2
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Kinlin LM, Weinstein M. Scurvy: old disease, new lessons. Paediatr Int Child Health 2023; 43:83-94. [PMID: 37795755 DOI: 10.1080/20469047.2023.2262787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/18/2023] [Indexed: 10/06/2023]
Abstract
Scurvy, the condition associated with severe vitamin C deficiency, is believed to be one of the oldest diseases in human history. It was particularly prevalent during the Age of Sail, when long sea voyages without access to fresh food resulted in an epidemic which claimed millions of lives; however, scurvy has existed across time and geography, occurring whenever and wherever diets are devoid of vitamin C. Young children, specifically, were affected by the emergence of 'infantile scurvy' in the 19th century owing to the use of heated milk and manufactured infant foods of poor nutritional quality. Scurvy continues to occur in at-risk groups. In children and youths, it is primarily observed in the context of autism spectrum disorder and feeding problems such as a limited food repertoire and high-frequency single food intake. Diagnosis may be delayed and invasive testing undertaken owing to clinicians' lack of familiarity with the disease, or the mistaken assumption that it is exclusively a disease of the past. The aetiology, clinical manifestations and treatment of scurvy are described. Its long history and current epidemiology are also reviewed, demonstrating that scurvy is very much a disease of the present. It is suggested that future efforts should focus on (i) anticipatory guidance and early nutritional intervention, informed by an understanding of scurvy's epidemiology, with the aim of preventing the disease in those at risk, and (ii) prompt recognition and treatment to minimise morbidity and healthcare costs.Abbreviations: ASD: autism spectrum disorder.
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Affiliation(s)
- Laura M Kinlin
- Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Michael Weinstein
- Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
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3
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Gandhi M, Elfeky O, Ertugrul H, Chela HK, Daglilar E. Scurvy: Rediscovering a Forgotten Disease. Diseases 2023; 11:78. [PMID: 37366866 DOI: 10.3390/diseases11020078] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/28/2023] Open
Abstract
Scurvy is a nutritional deficiency caused by low vitamin C levels that has been described since ancient times. It leads to a varied presentation, affecting multiple organ systems due to its role in the biochemical reactions of connective tissue synthesis. Common manifestations include gingival bleeding, arthralgias, skin discoloration, impaired wound healing, perifollicular hemorrhage, and ecchymoses. Although there has been a dramatic reduction in the prevalence of scurvy in modern times owing to vitamin C supplementation and intake, sporadic cases still occur. In developed countries, it is mainly diagnosed in the elderly and malnourished individuals and is associated with alcoholism, low socio-economic status, and poor dietary habits. Scurvy has been an unusual cause of gastrointestinal (GI) bleeding among other GI manifestations. It can be adequately treated and prevented via vitamin C supplementation.
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Affiliation(s)
- Mustafa Gandhi
- Department of Internal Medicine, University of Missouri, Columbia, MO 65211, USA
| | - Omar Elfeky
- Department of Medicine, University of Florida, Leesburg, FL 32611, USA
| | - Hamza Ertugrul
- Division of Gastroenterology and Hepatology, Charleston Area Medical Center, West Virginia University, Charleston, WV 25304, USA
| | - Harleen Kaur Chela
- Division of Gastroenterology and Hepatology, Charleston Area Medical Center, West Virginia University, Charleston, WV 25304, USA
| | - Ebubekir Daglilar
- Division of Gastroenterology and Hepatology, Charleston Area Medical Center, West Virginia University, Charleston, WV 25304, USA
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4
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Heinrich C. A curious case of leg pain. JAAPA 2023; 36:47-49. [PMID: 37097783 DOI: 10.1097/01.jaa.0000923556.50400.a8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Affiliation(s)
- Christopher Heinrich
- Christopher Heinrich practices in hospital medicine at the Cleveland (Ohio) Clinic Foundation. The author has disclosed no potential conflicts of interest, financial or otherwise
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5
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Quinn LA, Gilley SP, Ta AD, Frank BS, Foley CB, Moore JM. Case report: Pulmonary hypertensive crisis leading to cardiac arrest during endoscopic evaluation in a 6-year-old boy with autism, severe malnutrition, and undiagnosed scurvy. Front Pediatr 2022; 10:1008507. [PMID: 36389378 PMCID: PMC9650637 DOI: 10.3389/fped.2022.1008507] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 09/28/2022] [Indexed: 11/13/2022] Open
Abstract
Pediatric gastroenterologists are often responsible for the evaluation of malnutrition in the setting of selective eating. Endoscopic evaluation for conditions including eosinophilic esophagitis and celiac disease can help to identify and treat mucosal disease contributing to food selectivity. However, undiagnosed micronutrient deficiencies can cause cardiovascular derangements that significantly increase a patient's anesthetic risk. Vitamin C deficiency in particular, alone or in combination with severe malnutrition, is associated with a severe but reversible form of pulmonary arterial hypertension that, while life threatening in the acute phase, may significantly improve within days of starting ascorbic acid replacement therapy. Here we present a case of a 6-year-old boy with autism spectrum disorder (ASD), severe malnutrition, and undiagnosed chronic vitamin C deficiency who developed a pulmonary hypertensive crisis after induction of general anesthesia leading to cardiac arrest during endoscopic evaluation. While the association between food selectivity among youth with neurodevelopmental differences and vitamin C deficiency is well-described, and pulmonary hypertension is a recognized rare complication of scurvy, extant literature has not addressed next steps to improve patient outcomes. Using this case report as a foundation, we discuss specific patient populations to screen and treat for micronutrient deficiencies prior to anesthesia and propose a novel clinical algorithm for pre-anesthesia risk stratification and mitigation in patients specifically at risk for scurvy and associated pulmonary hypertension.
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Affiliation(s)
- Laura A. Quinn
- Department of Pediatrics, Section of Pediatric Gastroenterology, Hepatology and Nutrition, University of Colorado School of Medicine, Aurora, CO, United States
| | - Stephanie P. Gilley
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, CO, United States
| | - Allison D. Ta
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, CO, United States
| | - Benjamin S. Frank
- Department of Pediatrics, Section of Cardiology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Carolyn B. Foley
- Department of Anesthesiology, Division of Pediatric Anesthesiology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Jaime M. Moore
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, CO, United States
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6
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Abdou MM, Forey KP, Padrnos L. 24-Year-Old Woman With Menorrhagia, Mucosal Bleeding, and Easy Bruising. Mayo Clin Proc 2022; 97:1375-1379. [PMID: 35787865 DOI: 10.1016/j.mayocp.2022.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 01/14/2022] [Accepted: 01/21/2022] [Indexed: 10/17/2022]
Affiliation(s)
- Merna M Abdou
- Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Phoenix, AZ
| | - Kevin P Forey
- Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Phoenix, AZ
| | - Leslie Padrnos
- Advisor to residents and Consultant in Hematology and Oncology, Mayo Clinic, Phoenix, AZ.
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7
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Zhou JQ, Velimirovic M, Chang LL, Fenves AZ. Spontaneous haematomas and haematochezia due to vitamin C deficiency in a haemodialysis patient. BMJ Case Rep 2022; 15:e249711. [PMID: 35606035 PMCID: PMC9174824 DOI: 10.1136/bcr-2022-249711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2022] [Indexed: 11/04/2022] Open
Abstract
A man in his 50s with dialysis-dependent end-stage renal disease, several weeks history of progressive skin bruising and acute-onset gastrointestinal bleeding presented to the emergency department following a syncopal event during routine haemodialysis owing to profound hypotension. He was found to have a severe normocytic, normochromic anaemia requiring several blood transfusions. He followed a diet lacking fruits and vegetables and stopped taking renal multivitamins. All parameters of coagulation were unremarkable, but serum vitamin C level was undetectable, supporting a diagnosis of scurvy. Although typically associated with individuals who are at risk of malnourishment, such as those with alcohol use disorder, malabsorption, and those who experience homelessness, scurvy should be considered in patients receiving renal replacement therapy as vitamin C is removed during haemodialysis.
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Affiliation(s)
- James Q Zhou
- Harvard Medical School, Boston, Massachusetts, USA
- Hospital Medicine Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Marko Velimirovic
- Harvard Medical School, Boston, Massachusetts, USA
- Hospital Medicine Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Leslie L Chang
- Harvard Medical School, Boston, Massachusetts, USA
- Hospital Medicine Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Andrew Z Fenves
- Harvard Medical School, Boston, Massachusetts, USA
- Clinician Educator, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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8
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Advancements in Skin Delivery of Natural Bioactive Products for Wound Management: A Brief Review of Two Decades. Pharmaceutics 2022; 14:pharmaceutics14051072. [PMID: 35631658 PMCID: PMC9143175 DOI: 10.3390/pharmaceutics14051072] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/25/2022] [Accepted: 05/13/2022] [Indexed: 02/06/2023] Open
Abstract
Application of modern delivery techniques to natural bioactive products improves their permeability, bioavailability, and therapeutic efficacy. Many natural products have desirable biological properties applicable to wound healing but are limited by their inability to cross the stratum corneum to access the wound. Over the past two decades, modern systems such as microneedles, lipid-based vesicles, hydrogels, composite dressings, and responsive formulations have been applied to natural products such as curcumin or aloe vera to improve their delivery and efficacy. This article reviews which natural products and techniques have been formulated together in the past two decades and the success of these applications for wound healing. Many cultures prefer natural-product-based traditional therapies which are often cheaper and more available than their synthetic counterparts. Improving natural products’ effect can provide novel wound-healing therapies for those who trust traditional compounds over synthetic drugs to reduce medical inequalities.
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9
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Roncone DP. Environmental droplet keratopathy: a novel approach to nomenclature, classification, treatment and management. Clin Exp Optom 2022; 105:664-666. [PMID: 35378048 DOI: 10.1080/08164622.2022.2058869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- David P Roncone
- Eye Clinic, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA
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10
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Marquardt P, Raman G, Shen YM, Wang DH. Scurvy: a rare cause of haemarthrosis. BMJ Case Rep 2022; 15:e244594. [PMID: 35256359 PMCID: PMC8905988 DOI: 10.1136/bcr-2021-244594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 11/04/2022] Open
Abstract
A male in his 60s with a history of previously treated locally advanced head and neck cancer presented to the emergency department with atraumatic left knee pain and upper and lower extremity ecchymoses that had been present for 3 weeks. His initial laboratory results showed a normocytic anaemia, normal platelet count, slightly abnormal coagulation studies and normal inflammatory markers. Arthrocentesis of the left knee revealed haemarthrosis, and additional laboratory workup found an undetectable serum vitamin C (ascorbic acid) level consistent with scurvy. It was determined that scurvy had predisposed the patient to injury, leading to haemarthrosis. Following vitamin C supplementation, dietary and activity modifications, and acetaminophen as needed, the patient's serum vitamin C level normalised and his left knee pain and swelling improved. Scurvy is a rare cause of haemarthrosis, but it should be recognised in at-risk patients since treatment is effective.
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Affiliation(s)
- Patrick Marquardt
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Ganesh Raman
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Yu-Min Shen
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA
| | - David H Wang
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA
- VA North Texas Health Care System, Dallas, Texas, USA
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11
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Baluch A, Landsberg D. Scurvy in the Intensive Care Unit. J Investig Med High Impact Case Rep 2021; 9:23247096211067970. [PMID: 34939441 PMCID: PMC8721699 DOI: 10.1177/23247096211067970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/18/2021] [Accepted: 11/26/2021] [Indexed: 11/16/2022] Open
Abstract
Scurvy, caused by vitamin C deficiency, is a forgotten disease in the modern era of medicine. The prevalence of vitamin C deficiency in the United States is reported to be 7.1%. We present a case of a 56-year-old man with a history of chronic alcohol use who was admitted to the intensive care unit due to sepsis. He was found to have a rash on his hands and feet which consisted of palpable lesions as well as petechiae. Work up of the patient's skin pathology revealed ascorbic acid deficiency, also known as scurvy. This case highlights the importance of considering severe nutritional deficiency in patients with underlying alcohol use who present with skin findings that may mimic those of a vasculitis. Although rare, vitamin C deficiency still exists, and it is important to be aware of presenting signs and identify those who are at risk.
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Affiliation(s)
- Amarah Baluch
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
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12
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Berretta M, Quagliariello V, Maurea N, Di Francia R, Sharifi S, Facchini G, Rinaldi L, Piezzo M, Manuela C, Nunnari G, Montopoli M. Multiple Effects of Ascorbic Acid against Chronic Diseases: Updated Evidence from Preclinical and Clinical Studies. Antioxidants (Basel) 2020; 9:antiox9121182. [PMID: 33256059 PMCID: PMC7761324 DOI: 10.3390/antiox9121182] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 12/12/2022] Open
Abstract
Severe disease commonly manifests as a systemic inflammatory process. Inflammation is associated withthe enhanced production of reactive oxygen and nitrogen species and with a marked reduction in the plasma concentrations of protective antioxidant molecules. This imbalance gives rise to oxidative stress, which is greater in patients with more severe conditions such as sepsis, cancer, cardiovascular disease, acute respiratory distress syndrome, and burns. In these patients, oxidative stress can trigger cell, tissue, and organ damage, thus increasing morbidity and mortality. Ascorbic acid (ASC) is a key nutrient thatserves as an antioxidant and a cofactor for numerous enzymatic reactions. However, humans, unlike most mammals, are unable to synthesize it. Consequently, ASC must be obtained through dietary sources, especially fresh fruit and vegetables. The value of administering exogenous micronutrients, to reestablish antioxidant concentrations in patients with severe disease, has been recognized for decades. Despite the suggestion that ASC supplementation may reduce oxidative stress and prevent several chronic conditions, few large, randomized clinical trials have tested it in patients with severe illness. This article reviews the recent literature on the pharmacological profile of ASC and the role of its supplementation in critically ill patients.
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Affiliation(s)
- Massimiliano Berretta
- Department of Clinical and Experimental Medicine, University of Messina, 98121 Messina, Italy;
- Correspondence:
| | - Vincenzo Quagliariello
- Division of Cardiology, Istituto Nazionale Tumori—IRCCS Fondazione “G. Pascale”, 80131 Napoli, Italy; (V.Q.); (N.M.)
| | - Nicola Maurea
- Division of Cardiology, Istituto Nazionale Tumori—IRCCS Fondazione “G. Pascale”, 80131 Napoli, Italy; (V.Q.); (N.M.)
| | - Raffaele Di Francia
- Italian Association of Pharmacogenomics and Molecular Diagnostics (IAPharmagen), 60126 Ancona, Italy;
| | - Saman Sharifi
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35100 Padova, Italy; (S.S.); (M.M.)
| | - Gaetano Facchini
- Division of Medical Oncology, “S. Maria delle Grazie” Hospital—ASL Napoli 2 Nord, 80126 Pozzuoli, Italy;
| | - Luca Rinaldi
- Department of Advanced Medical and Surgical Sciences, University of Campania “L. Vanvitelli”, 80121 Napoli, Italy;
| | - Michela Piezzo
- Division of Breast Medical Oncology, Istituto Nazionale Tumori—IRCCS Fondazione “G. Pascale”, 80131 Napoli, Italy;
| | - Ceccarelli Manuela
- Division of Infectious Disease, University of Catania, 95122 Catania, Italy;
| | - Giuseppe Nunnari
- Department of Clinical and Experimental Medicine, University of Messina, 98121 Messina, Italy;
| | - Monica Montopoli
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35100 Padova, Italy; (S.S.); (M.M.)
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13
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Guellich A, Tella E, Mahé E. [Scurvy presenting with low-extremity necrotic and purpuric ulcers: Two cases]. Rev Med Interne 2020; 42:214-217. [PMID: 33203540 DOI: 10.1016/j.revmed.2020.10.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/23/2020] [Accepted: 10/28/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Scurvy is a clinical syndrome resulting from ascorbic acid deficiency. Although presently rare in the developed world, it continues to occur within certain susceptible populations, particularly the elderly and those with dietary habits with low vitamin C intake. CASES Two men aged 87 and 69 were referred with multifactorial, progressive ulceration of the lower limbs, without scarring, in a context of arterial disease and other associated comorbidities. In both cases, the level of vitamin C was undetectable. An improvement in the necrotic component and in the purpura was promptly observed after vitamin C supplementation. CONCLUSIONS Diagnosis of scurvy can be challenging. This report highlights the importance of maintaining a high index of suspicion for scurvy in atypical necrotic ulcerations of lower extremities with poor response to standard therapy especially in populations at high risk of vitamin C deficiency. Early diagnosis can improve patient prognosis.
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Affiliation(s)
- A Guellich
- Service de dermatologie et médecine vasculaire, hôpital Victor-Dupouy, 69, rue du Lieutenant-Colonel-Prud'hon, 95100 Argenteuil, France
| | - E Tella
- Service de dermatologie et médecine vasculaire, hôpital Victor-Dupouy, 69, rue du Lieutenant-Colonel-Prud'hon, 95100 Argenteuil, France
| | - E Mahé
- Service de dermatologie et médecine vasculaire, hôpital Victor-Dupouy, 69, rue du Lieutenant-Colonel-Prud'hon, 95100 Argenteuil, France.
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Seifer CM, Glaser A, Gesiotto Q, Waknin R, Oller KL. Petechiae, Purpura, and a Pandemic: A Recipe for Scurvy. Cureus 2020; 12:e10960. [PMID: 33209521 PMCID: PMC7667612 DOI: 10.7759/cureus.10960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2020] [Indexed: 11/30/2022] Open
Abstract
This case report presents the case of a 28-year-old man who developed scurvy during the coronavirus disease 2019 (COVID-19) pandemic. Scurvy is a disease resulting from a nutritional deficiency of vitamin C (ascorbic acid). It is a rare condition, whose signs and symptoms can vary from patient to patient. The treatment is vitamin C supplementation, which is often followed by a swift recovery. To our knowledge, this is the first reported case of scurvy during the COVID-19 pandemic. This article highlights a rare acquired bleeding disorder, which may manifest more commonly during a pandemic due to food scarcity or stay-at-home mandates in those already at risk.
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Affiliation(s)
- Charles M Seifer
- Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Alexander Glaser
- Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Quinto Gesiotto
- Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Roy Waknin
- Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Kellee L Oller
- Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
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15
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Cheah SC, Tang IP, Matthew TJH, Ooi MH, Husain S. Spontaneous orbital haematoma in a scurvy child: A forgotten diagnosis. Int J Pediatr Otorhinolaryngol 2020; 137:110224. [PMID: 32896344 DOI: 10.1016/j.ijporl.2020.110224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/20/2020] [Accepted: 06/20/2020] [Indexed: 10/23/2022]
Abstract
Spontaneous unilateral orbital haematoma in children is not common and very rarely caused by scurvy. Scurvy is a clinical syndrome with a spectrum of clinical manifestations due to severe prolonged vitamin C deficiency leading to impairment of collagen synthesis over skin, bone, teeth and blood vessels. This paper presents a unique case of a 7- year-old girl with learning difficulty who presented with spontaneous right proptosis due to scurvy. Imaging studies suggestive of intra- orbital extraconal haemorrhage. The child was treated with a higher than recommended dose of vitamin C initially in emergency situation. She responded well and discharged without complication. Spontaneous orbital haematoma due to scurvy is very rare with less than 10 cases published in literature. The present case should raise the awareness regarding this forgotten disease and importance of balance nutrition amongst children.
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Affiliation(s)
- Siew Chung Cheah
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000, Cheras, Kuala Lumpur, Malaysia; Department of Otorhinolaryngology-Head and Neck Surgery, Sarawak General Hospital, 93586, Kuching, Sarawak, Malaysia.
| | - Ing Ping Tang
- Department of Otorhinolaryngology-Head and Neck Surgery, Sarawak General Hospital, 93586, Kuching, Sarawak, Malaysia; Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak, Malaysia
| | - Tong Jong Haw Matthew
- Department of Ophthalmology, Sarawak General Hospital, 93586, Kuching, Sarawak, Malaysia
| | - Mong How Ooi
- Department of Paediatrics, Sarawak General Hospital, 93586, Kuching, Sarawak, Malaysia
| | - Salina Husain
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000, Cheras, Kuala Lumpur, Malaysia
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