Scurvy - a disease caused by an acute shortage of vitamin C. Lack of vitamin C results in disruption of the synthesis of collagen, the connective tissue loses its strength. While scurvy - a consequence of vitamin deficiency, not a disorder of the hematopoietic system, it is accompanied by capillary bleeding and progressive anemia. When complete cessation of receipt of ascorbic acid in the body, scurvy develops in about 4-12 weeks; in hypovitaminosis C clinical manifestations are less pronounced and appear at a later date, usually within 4-6 months.

Scurvy belongs to the category of hemorrhagic (bleeding) disorders, which are characterized by a tendency to spontaneous bleeding. She rarely appears certain diseases, the most likely epidemic and endemic.

The first reliable information about the disease belong to the era of the Crusades, the beginning of the XIII century, and relate to diseases among the ship's crew. Even more widespread scurvy received in the second half of the XV century, during a round the world navigation.

It has long been associated with the occurrence of scurvy, lack or bad quality of food, especially with the use of known nutrients, namely corned beef (on ships), with a lack of plant foods, especially green vegetables. Scorbutic epidemic often observed during the poor harvest of potatoes. Other observers have noted the influence of tainted drinking water, damp, cramped space for housing, excessive physical stress.

Scurvy begins gradually symptoms of a general nature, which are expressed fatigue, weakness, a feeling of pressure or tightness in the chest, palpitations. These phenomena will soon join rheumatoid nagging pain in the sacrum and in the limbs, especially in the legs. In more severe cases, patients generally do not leave the bed, is very chilly, sleepy, apathetic. These symptoms last from several days to two weeks. Then, to develop the characteristic symptoms of scurvy: the defeat of the gums and spontaneous hemorrhage.

Signs and symptoms of scurvy

The first signs of scurvy appear after 4 to 12 weeks after discontinuation of vitamin C, but with little of his arrival with food (hypovitaminosis C) - 4 - 6 months. General weakness, drowsiness, fatigue, irritability, drowsiness, dizziness, vague pain in the calf muscles and joints, weight loss. These symptoms do not belong to a specific, but they can be suspected scurvy if they are preceded by the appearance of starvation Fasting - this is natural   or food products that do not contain vitamin C, as well as long-term diarrhea to malnutrition due to malabsorption of food in the intestines.

Subsequently observed characteristic changes in the gums of scurvy: pale gums initially, then become cyanotic, interdental papillae are swollen and bleed at the slightest touch to them; sponge around the teeth appear blue-purple growths forming rollers; these expansions of - hemorrhage. Patients report pain when chewing, and increased salivation. In severe scurvy, as well as in the presence of patients with secondary infection joins the teeth, gums appear on the ulcer, there is bad breath, teeth become loose and fall out. The skin becomes dry, it becomes yellowish-brown color; characterized by bleeding in the skin (mainly on the lower limbs), which are located mainly around the hair follicles, protrude above the level of the skin and give it the appearance of a grater. First haemorrhage are red What color goes red: beware Then acquire a blue-red and brownish hue. In severe cases, there is extensive hemorrhage in the conjunctiva, the subcutaneous tissue (primarily in the buttocks, posterior thigh and popliteal pits) in the thickness of muscle (usually calf), under the periosteum in the tissue around the joints. With significant hemorrhages visible solid formed hematoma, causing pain. Because of the pain in muscles and joints moving patients is difficult, often they go, knees bent.

Possible hemorrhage in the internal organs (e.g., stomach, intestines, lungs, kidneys, pleura, pericardium), and into the anterior chamber. In such cases, the manifestations of the disease can be attached hematemesis, hemoptysis, hematuria. When scurvy observed inhibition of motor and secretory functions of the stomach and intestines, often marked by anemia, an enlarged spleen may sometimes liver. Often there are low-grade fever, decreased pressure. Signs of heart disease (dyspnea, palpitations, weakening of the cardiac impulse, deaf tones) are usually associated with a lack of food or other vitamins or protein due to the addition of infectious and other diseases. Because of bleeding in different fabrics possible complications - fractures, persistent restriction of mobility in joints.

Treatment and prevention of scurvy

Treatment consists in the appointment of nutrition to include foods rich in vitamin Vitamins for everyone   C (fresh fruits, berries, vegetables, juices), and preparations of ascorbic acid orally or parenterally at 250 mg four times a day until the disappearance of bleeding (usually within 2 - 4 weeks) followed by reduction of the daily dose of up to 200 - 100 mg. In children, the initial daily dose is 100 - 300 mg. To reduce the inflammation of the mucous membrane of the mouth rinse used a weak disinfectant solution of potassium permanganate, hydrogen peroxide, oil solutions of vitamins A and E. In anemia prescribe iron supplements, vitamin B12. In the presence of muscular infiltration and by limiting the mobility of the joints is performed physical therapy procedures, including baths, massages; prescribe physiotherapy.