Four cases of
scurvy diagnosed within a period of two years are reported. They comprised 2 male patients with heavy
nicotine and
alcohol abuse, a 35-year-old woman with
malnutrition due to food supplements
phobia, and a 69-year-old woman with
malnutrition due to
dementia and social isolation. All four patients were adynamic and anemic. Three patients showed typical dermatologic signs with hemorrhagic hyperceratosis, suffusions or cork-screw hair. Two patients complained of parodontol disorders. Other symptoms were gastrointestinal
bleeding,
sicca syndrome,
retinal bleeding,
subdural hematoma,
edema and
arthralgia. Associated disorders were
folic acid and
vitamin B12 depletion in two cases, and nephropathy and
pneumonia with
pneumothorax in one case each. In all cases the serum asorbic
acid concentration was below the scorbutic level of 11 mumol/l. Historical data, pathogenesis, incidence, clinical presentation, diagnosis and
therapy of
scurvy are discussed. We conclude that
scurvy can be observed even in a developed country such as Switzerland at the end of the 20th century. The real incidence may be underestimated because symptoms are not well known and disappear rapidly after admission because of sufficient
vitamin C content in normal diet. Patients at risk are socially isolated alcoholics, old people, psychiatric patients and diet enthusiasts. Usually
scurvy occurs in conjunction with other deficiencies. Smoking and acute illness enhance
ascorbic acid depletion. With a knowledge of the symptomatology of
scurvy, it is easy to diagnose and treatment is simple and effective.