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| | [[User:Wajeeha Dogar|Wajeeha Aiman, M.D.]][mailto:wajeeha.dogar174@gmail.com] |
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| {{Scurvy}}
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| {{CMG}}; {{AE}}
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| ==Overview==
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| '''Scurvy''' is a chronic [[deficiency disease]] of [[vitamin C]], which is necessary for normal [[collagen]] formation in humans. L-ascorbic acid, the scientific name for vitamin c, is derived from the Latin name, scorbutus. Early symptoms of this disease are fatigue, weakness, and sore arms and legs. Without treatment, changes in [[hair]], [[skin]], and [[gums]] occur. <ref name="pmid25983516">{{cite journal| author=Agarwal A, Shaharyar A, Kumar A, Bhat MS, Mishra M| title=Scurvy in pediatric age group - A disease often forgotten? | journal=J Clin Orthop Trauma | year= 2015 | volume= 6 | issue= 2 | pages= 101-7 | pmid=25983516 | doi=10.1016/j.jcot.2014.12.003 | pmc=4411344 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25983516 }} </ref> As scurvy worsens there can be [[personality changes]], poor [[wound healing]] and ultimately leading to death due to [[bleeding]] or [[infection]]. <ref name="pmid"Vitamin C". Office of Dietary Supplements. 11 Fe">{{cite journal| author=Lefkowitz RJ| title=Identification of adenylate cyclase-coupled beta-adrenergic receptors with radiolabeled beta-adrenergic antagonists. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 18 | pages= 1651-8 | pmid="Vitamin C". Office of Dietary Supplements. 11 Fe | doi=10.1016/0006-2952(75)90001-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11 }} </ref>
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| Previously, this disease was common among pirates, sailors, and all others who were separated from the resources of vitamin c e.g. [[fruits]] and [[vegetables]] for extended periods. It takes a month with low or no vitamin c to cause symptoms. <ref name="pmid"Scurvy". GARD. 1 September 2016. Archived from t">{{cite journal| author=Makar AB, McMartin KE, Palese M, Tephly TR| title=Formate assay in body fluids: application in methanol poisoning. | journal=Biochem Med | year= 1975 | volume= 13 | issue= 2 | pages= 117-26 | pmid="Scurvy". GARD. 1 September 2016. Archived from t | doi=10.1016/0006-2944(75)90147-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1 }} </ref>
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| In infants, scurvy is sometimes referred to as '''Barlow's disease''', named after Sir [[Thomas Barlow]] (1845–1945), <ref name="pmid6423046">{{cite journal| author=Evans PR| title=Infantile scurvy: the centenary of Barlow's disease. | journal=Br Med J (Clin Res Ed) | year= 1983 | volume= 287 | issue= 6408 | pages= 1862-3 | pmid=6423046 | doi=10.1136/bmj.287.6408.1862 | pmc=1550031 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6423046 }} </ref> a British [[physician]] who described it. Other eponyms include '''Moeller's disease''' and '''Cheadle's disease'''. In the modern world, scurvy rarely presents in adults, infants and elderly are affected more. <ref name="pmidSthoeger ZM, Sthoeger D. Harefuah. 1991;120(6):332">{{cite journal| author=Rajcáni J, Krobová J, Málková D| title=Distribution of Lednice (Yaba 1) virus in the chick embryo. | journal=Acta Virol | year= 1975 | volume= 19 | issue= 6 | pages= 467-72 | pmid=Sthoeger ZM, Sthoeger D. Harefuah. 1991;120(6):332 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1991 }} </ref> <ref name="pmidHampl JS, Taylor CA, and Johnston CS. (2004). "Vi">{{cite journal| author=Fowler NO, McCall D, Chou TC, Holmes JC, Hanenson IB| title=Electrocardiographic changes and cardiac arrhythmias in patients receiving psychotropic drugs. | journal=Am J Cardiol | year= 1976 | volume= 37 | issue= 2 | pages= 223-30 | pmid=Hampl JS, Taylor CA, and Johnston CS. (2004). "Vi | doi=10.1016/0002-9149(76)90316-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2004 }} </ref>
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| Vitamin C, a [[water soluble]] vitamin, can easily be destroyed by [[pasteurization]]. So bottle fed babies, not supplemented with adequate vitamin, can easily develop scurvy. For this reason, vitamin C is added to all approved baby formulas. If mothers take adequate amount of vitamin C, then [[breast milk]] is sufficient for the babies need of this vitamin.
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| ==Pathophysiology==
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| === Physiology ===
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| Vitamins are very important for the formation and normal functioning of [[enzymes]] that are responsible for multiple processes in the human body.<ref name="pmidPrice, Catherine (2017). "The Age of Scurvy". Dist">{{cite journal| author=Ehrhart IC, Parker PE, Weidner WJ, Dabney JM, Scott JB, Haddy FJ| title=Coronary vascular and myocardial responses to carotid body stimulation in the dog. | journal=Am J Physiol | year= 1975 | volume= 229 | issue= 3 | pages= 754-60 | pmid=Price, Catherine (2017). "The Age of Scurvy". Dist | doi=10.1152/ajplegacy.1975.229.3.754 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2017 }} </ref> [[Ascorbic acid]] is necessary for accelerating [[amidation]] reactions and [[hydroxylation]] in normal collagen synthesis. The hydroxylation of [[lysine]] and [[proline]] residues occurs in [[endoplasmic reticulum]] and leads to [[hydroxylysine]] and [[hydroxyproline]], respectively. Enzymes responsible for these reactions are [[lysyl hydroxylase]] and [[prolyl hydroxylase]]. For healthy skin, bone, muscles, [[cartilage]], blood vessels, and other connective tissues, the primary structure [[collagen]] protein is required with a proper synthesis and normal functioning.
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| === Pathogenesis ===
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| Defective collagen leads to abnormalities in all connective tissue areas. In blood vessels, defective connective tissue leads to fragile capillaries and causes bruising, abnormal bleeding, and internal hemorrhages. Similarly, teeth loosen, bones are easily breakable, recurrence of fractures, and poor wound healing. Scurvy is fatal if left untreated. <ref name="pmidPrice, Catherine (2017). "The Age of Scurvy". Dis">{{cite journal| author=Ehrhart IC, Parker PE, Weidner WJ, Dabney JM, Scott JB, Haddy FJ| title=Coronary vascular and myocardial responses to carotid body stimulation in the dog. | journal=Am J Physiol | year= 1975 | volume= 229 | issue= 3 | pages= 754-60 | pmid=Price, Catherine (2017). "The Age of Scurvy". Dis | doi=10.1152/ajplegacy.1975.229.3.754 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2017 }} </ref>
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| ==Genetics==
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| ==Associated Conditions==
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| ==Gross Pathology==
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| ==Microscopic Pathology==
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| ==References==
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