What Laboratory Animal(S) Is/are Prone To Developing Scurvy

Introduction [edit | edit source]

Vitamin C deficiency, also known as scurvy, is a affliction primarily associated with socioeconomic status and access to food. Signs and symptoms are ofttimes readily visible in individuals who develop this affliction. The classic constellation of corkscrew hairs, perifollicular hemorrhage, and gingival bleeding is highly suggestive of vitamin C deficiency.^[ane]

Image 1: Crystals of vitamin C

Etiology [edit | edit source]

Nearly animals require no exogenous vitamin C. For humans, however, vitamin C is an essential vitamin.

Humans lack the enzyme 50-gulonolactone oxidase, and people must ingest it. A mutation in the cistron coding for L-gulonolactone oxidase occurred, which no longer allows the human trunk to synthesize vitamin C. Thus, making it necessary for vitamin C to be taken in through the human being nutrition to ensure the body is able to aid in wound healing, scar germination, repairing cartilage, bone, and teeth, and the ability to blot atomic number 26.

• Vitamin C deficiency and its manifestations have largely been a product of inadequate dietary intake.
• Vitamin C is naturally plant in fresh fruits and vegetables; for example, grapefruits, oranges, lemons, limes, potatoes, spinach, broccoli, cherry peppers, and tomatoes.
• Up to ninety% of vitamin C is consumed in the form of vegetables and fruits. Lack of exposure to these foods has been the nearly frequent cause of the deficiency.
• Additionally, vitamin C is estrus-sensitive, and historically, grooming (boiling or cooking) has removed the nutritional value.
• The vitamin C pool in the body is usually depleted in 4-12 weeks if 1 stops the intake of the vitamin.
• Total body storage of vitamin C is 1500 mg, and clinical features of deficiency occur after that level is reduced to less than 350 mg^[ane]

Epidemiology [edit | edit source]

Vitamin C deficiency is defined as a serum concentration of less than 11.four umol/L, and prevalence varies beyond the globe

• Equally depression every bit vii.1% in the United States
• Up to 73.9% in north India.

Although vitamin C deficiency is common, even in industrialized countries, overt scurvy is rare. Infantile incidence is also uncommon as both chest milk and fortified formula are an adequate source.

The post-obit populations are at increased risk for a vitamin C inadequacy that could develop into a diagnosis of scurvy without appropriate dietary management.

• Smokers^[ii]
• Infants fed evaporated or boiled milk^[2] and Children with restricted diets^[3]
• Children with autism, developmental filibuster, and cerebral palsy^[3]
• Sailors at bounding main for months^{[3] [four]}
• Third world countries with limited foods ^[2]
• Low income.
• Individuals with malabsorption^[2]
• Individuals with cancer ^[2]
• Individuals with chronic diseases such equally end-stage renal disease or on hemodialysis^{[1] [2]}

Pathophysiology [edit | edit source]

Scurvy as a clinical manifestation of astringent vitamin C deficiency is caused past ascorbic acids role in collagen synthesis. Collagen type Four is the principal constituent of claret vessel walls, peel, and specifically, the basement membrane zone separating the epidermis from the dermis. Changes include:

• Epigenetic Dna hypermethylation and inhibition of the transcription of various types of collagen found in skin, blood vessels, and tissue.
• Bone germination is altered and become brittle.
• The central feature of scurvy is hemorrhage which tin can occur in almost whatsoever organ.^[one]

Vitamin C and Sarcopenia [edit | edit source]

Bereft dietary vitamin C intake may accept effects on muscles.

• Around 2-thirds of our torso's total vitamin C is found in skeletal muscle. It'southward used for making carnitine, a crucial substance that provides free energy for muscles to office, and collagen, which is an essential structural component of muscle.
• In improver, vitamin C is a stiff antioxidant that tin help to annul costless radical molecules, which increase when nosotros age. Unopposed, these free radicals can contribute to the destruction of muscle cells.

Studies have institute the people who consumed the highest amount of vitamin C in their nutrition had the greatest musculus mass.

• The biggest departure was seen in women: those women in the highest category of vitamin C consumption had muscle mass 3% greater than those in the lowest category.
• These differences are probable to be clinically relevant, especially given that nigh people are estimated to lose 0.5% to one% of muscle mass every twelvemonth after age fifty.
• These findings build on the concept that optimal diet may help reduce the turn down in muscle. We should encourage all people to follow the healthy eating guidelines and eat a broad variety of vegetables and fruits each day, not only for general health but to protect their muscles.^[v]

Characteristics/Clinical Presentation [edit | edit source]

Vitamin C deficiency can atomic number 82 to the following signs and symptoms:^[2]

• Anaemia
• Bleeding gums
• Decreased power to fight infection
• Decreased wound-healing rate
• Dry and splitting hair
• Easy bruising
• Gingivitis (inflammation of the gums)
• Nosebleeds
• Possible weight gain because of slowed metabolism
• Rough, dry, scaly skin
• Swollen and painful joints
• Weakened tooth enamel

Associated Co-morbidities [edit | edit source]

Osteopenia - osteopenia is divers past bone densitometry as a T score -1 to -2.5. At that place are many causes for osteopenia including calcium and vitamin D deficiency and inactivity. Genetics plays an important office in a person's os mineral density and oft Caucasian women with a thin body habitus who are premenopausal are institute to have osteopenia.^[half-dozen]

Iron deficiency - As the name implies, iron deficiency anemia is due to bereft fe. Without enough iron, your body tin can't produce enough of a substance in red blood cells that enables them to deport oxygen (hemoglobin). As a result, iron deficiency anemia may exit yous tired and brusque of breath.^[7]

Anaemia

Folate deficiency - Folic acid (vitamin B9) works with vitamin B12 and vitamin C to help the torso pause down, employ, and brand new proteins. The vitamin helps form red and white claret cells. It also helps produce DNA. Folate is not stored in the body in big amounts, your blood levels will get low later on only a few weeks of eating a diet low in folate.^[8]

Vitamin K deficiency - Vitamin Thou (VK) deficiency tin can occur in any age group simply is encountered almost often in infancy. VK, an essential, lipid-soluble vitamin that plays a vital role in the product of coagulation proteins^{[9] [10]}

Menagement [edit | edit source]

• 

  Direct replacement of vitamin C is standard, with up to 300 mg daily for children and 500 mg to 1000 mg daily for adults. The endpoint of replacement is one month or upon resolution of clinical sequelae.
• In improver to immediate supplementation, brainwash the patient on lifestyle modifications to ensure adequate intake, and recommend cessation of alcohol, and tobacco use.
• In the absenteeism of a deficiency, daily requirements are up to 45 mg per 24-hour interval in children, ninety mg per solar day for men, 75 mg per twenty-four hour period for women, and up to 120 mg per mean solar day for women who are lactating^[1].

When choosing foods high in vitamin C, it is too of import to consider how the food is prepared. Storing the food for long periods of fourth dimension or cooking the product a certain way can reduce the amount of vitamin C the food contains. The best source of vitamin C is establish most when consuming raw fruits and vegetables with high daily values. Cooking losses may exist reduced past microwaving or steaming the food. Light exposure tin can as well reduce the amount of vitamin C institute in foods. According the NIH, juices kept in cartons should exist chosen rather than juice contained in a clear bottle.

Dietary Management/Food Sources Vitamin C can be constitute in some foods naturally and other foods are fortified with vitamins. Table 2 lists the fruits and vegetables that contain naturally loftier in vitamin C content. Many cereals and beverages are fortified with vitamin C. Checking food labels can provide data on the amount of vitamin C contained in the product.

Table ii. Fruits and vegetables that incorporate loftier amounts of vitamin C.

Fruits	Vegetables
Cantaloupe	Broccoli
Orangish	Brussel Sprouts
Grapefruit	Cauliflower
Kiwi fruit	Spinach
Mango	Sweet and white potatoes
Papaya	Tomatoes and tomato juice
Pineapple	Wintertime squash
Strawberries	Greenish/red peppers
Raspberries	Turnip greens
Blueberries	Cabbage
Cranberries
Watermelon

Diagnostic Tests/Lab Tests/Lab Values [edit | edit source]

Plasma levels: A fasting serum ascorbic acid level greater than 0.6 mg/dL rules out scurvy. Scurvy mostly occurs at levels beneath 0.1 mg/dL.^[xi]
Leukocyte levels: The level of vitamin C in leukocytes more accurately correlates to tissue stores compared with serum levels, considering these cells are non affected acutely by circadian rhythm or dietary changes. A level of nix indicates latent scurvy. Levels of 0-vii mg/dL reflect a state of deficiency.^[11]
Urinary levels: A more ordinarily used method is the ascorbic acrid tolerance test, which quantitates urinary ascorbic acid over the six hours post-obit an oral load of 1 g of ascorbic acid in h2o.^[11]
Radiographic findings: in infantile scurvy are diagnostic and may show any of the following:^[11]

• Subperiosteal elevation
• Fractures and dislocation
• Alveolar os reabsorption
• Ground-drinking glass appearance of cortex

Prognosis [edit | edit source]

Comeback of ramble symptoms often occurs within 24 hours, with spontaneous bleeding improving over days to weeks. Corkscrew hairs take upward to a month to resolve, and complete resolution is usually seen by 3 months. Bone abnormalities may require surgical intervention.

Differential Diagnosis [edit | edit source]

Differential diagnosis includes many cutaneous purpuric pathologies including:

• Immune thrombocytopenic purpura, Henoch-Schonlein purpura, disseminated intravascular coagulation, Rocky Mountain spotted fever, meningococcemia, or hypersensitivity vasculitis.
• Mucosal involvement may mimic necrotizing gingivitis.
• Other vitamin deficiencies including niacin (B3), biotin (B7), and zinc may nowadays with peel changes.^[two]

References [edit | edit source]

1. ↑ ^{i.0 1.1 1.two 1.iii 1.4} Maxfield L, Crane JS. Vitamin C deficiency (scurvy). StatPearls [Internet]. 2019 Nov nineteen.Available from: https://world wide web.statpearls.com/articlelibrary/viewarticle/28798/(accessed 5.3.2021)
2. ↑ ^{ii.0 two.i ii.two two.3 2.four 2.5 2.6 ii.7} Wax E, Zieve D, Ogilvie I. Vitamin C [updated Feb ii, 2015; cited 2016 April 8]. Bachelor from: https://world wide web.nlm.nih/gov/medlineplus/ency/commodity/002404.htm.
3. ↑ ^{3.0 3.1 3.two} Alqanatish JT, Alqahtani F, Alsewairi WM, Al-kenaizan S. Childhood scurvy: an unusual cause of refusal to walk in a child. Pediatric rheumatology online journal. 2015;thirteen-23.
4. ↑ Chaudhry SI, Newell EL, Lewis RR, Black MM. Scurvy: a forgotten affliction. Clinical & Experimental Dermatology. 2005;30(6):735-six
5. ↑ The Conversation Vitamin C could help older adults retain muscle mass – new research Available from: https://theconversation.com/vitamin-c-could-help-older-adults-retain-muscle-mass-new-inquiry-145125(accessed 6.3.2021)
6. ↑ Karaguzel G, Holick MF. Diagnosis and treatment of osteopenia. Reviews in endocrine & metabolic disorders. 2010;eleven(4):237-51.
7. ↑ Mayo Clinic Staff. Atomic number 26 Deficiency Anemia 2014 [updated Jan. 2, 2014; cited 2016 Apr 8]. Available from: http://world wide web.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/nuts/definition/con-20019327.
8. ↑ Wax E, Zieve D, Ogilvie I. Folate Deficiency [updated July 14, 2015; cited 2016 APril 8]. Available from: https://www.nlm.nih.gov/medlineplus/ency/article/000354.htm.
9. ↑ Nguyen-Khoa D-T, Patel P. Vitamin K Deficiency [updated Dec. 18, 2015; cited 2016 April 8]. Bachelor from: http://emedicine.medscape.com/article/126354-overview.
10. ↑ Goebel L, July M. Scurvy Overview: Prognosis 2015 [updated Sep 23, 2015; cited 2016 April five]. Available from: http://emedicine.medscape.com/article/125350-overview#a7.
11. ↑ ^{11.0 xi.1 11.two 11.3} Goebel L. July Yard. Scurvy Workup 2015 [updated Sep 23, 2015; cited 2016 Apr 5]. Available from: http://emedicine.medscape.com/article/125350-workup#showall.

Source: https://www.physio-pedia.com/Vitamin_C_Deficiency_%28Scurvy%29

Posted by: garzaholoccure85.blogspot.com

Share this post