Despite its connotations with ancient sailors, scurvy isn’t a relic of the past, according to a new report
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The report chronicles the scurvy diagnosis of a 65-year-old woman who visited a downtown Toronto hospital emergency room last year for leg weakness. With mobility issues and little social support, her ability to go grocery shopping and make meals was limited. The researchers note that her diet consisted of primarily nonperishable foods, such as canned soup and fish, white bread and processed cheese. She didn’t eat fresh produce or take any vitamins or supplements.
Although (scurvy) is often asymptomatic and rarely represents the primary concern for presentation to acute care, the condition should not be considered only an archaic diagnosis of 18th-century seafarers.
“Although her diet alone would have predisposed her to hypovitaminosis C, cigarette smoking likely played a role as well,” the researchers wrote, which can contribute to the vitamin deficiency. Once the patient started vitamin C treatment, her symptoms improved.
The researchers note that diagnosis can be challenging because many symptoms of scurvy, such as fatigue, weakness and irritability, are general.
In addition to looking out for scurvy in patients at higher risk for vitamin C deficiency, “including pediatric patients, those who smoke cigarettes or have a substance use disorder, malabsorption syndrome, or restrictive eating pattern (e.g., autism spectrum disorder or tea and toast diet),” the researchers note that doctors should assess for food insecurity, “an equally important and ubiquitous risk factor for hypovitaminosis C.”
“Although hypovitaminosis C is often asymptomatic and rarely represents the primary concern for presentation to acute care, the condition should not be considered only an archaic diagnosis of 18th-century seafarers,” the CMAJ report states. “Clinicians must approach patients with undifferentiated symptoms using a careful history and broad differential, especially those at higher risk for nutrient deficiencies, including people with low socioeconomic status, or isolated older adults.”
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