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For further information, see CMDT Part 31-16: Vitamin C (Ascorbic Acid) Deficiency

KEY FEATURES

  • Most commonly due to dietary inadequacy among older adults and patients with alcohol use disorder

  • Individuals who smoke cigarettes are also at risk as well as patients with chronic illnesses such as cancer and chronic kidney disease

CLINICAL FINDINGS

  • Early: nonspecific malaise and weakness

  • Late: scurvy

  • Initial characteristics of scurvy

    • Perifollicular hemorrhages

    • Perifollicular hyperkeratotic papules

    • Petechiae

    • Purpura

    • Splinter hemorrhages

    • Bleeding gums

    • Hemarthroses

    • Subperiosteal hemorrhages

  • Characteristics of late scurvy

    • Edema

    • Oliguria

    • Neuropathy

    • Intracerebral hemorrhage

    • Death

  • Anemia is common

  • Wound healing is impaired

DIAGNOSIS

  • Characteristic skin lesions

  • Atraumatic hemarthrosis

  • Decreased plasma ascorbic acid levels, typically < 0.2 mg/dL

TREATMENT

  • Ascorbic acid (vitamin C), 300–1000 mg orally once daily

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