Vitamin C Deficiency In Childhood

Description

Vitamin C is required as a redox agent, reducing metal ions in many enzymes and removing free radicals. Vitamin C Deficiency or Scurvy , also known as ascorbic acid deficiency , scorbutus , leads to impaired collagen synthesis, causing capillary fragility, poor wound healing and bony abnormalities in deficient children.
Humans, other primates and guinea pigs are unable to synthesise L-ascorbic acid (vitamin C), so they require it in their diet. The enzyme, L-gluconolactone oxidase , which would usually catalyse the conversion of L-gluconogammalactone to L-ascorbic acid, is defective due to a mutation or inborn error in carbohydrate metabolism.
The incidence of scurvy peaks in children 6-12 months of age who are fed a diet deficient in citrus fruits or vegetables.

Symptoms and Signs

Early symptoms are malaise and lethargy. After 1-3 months, patients develop shortness of breath and bone pain. Other symptoms include skin changes with roughness, easy bruising and petechiae, gum disease, loosening of teeth, poor wound healing and emotional changes. Dry mouth and dry eyes may occur. In the late stages, jaundice, generalised oedema, oliguria, neuropathy, fever and convulsions can be seen. Hypotension may be seen late in the disease.
Scorbutic rosary (sternum sinks inward) may occur in children. Fractures and dislocations, as well as tenderness of bones in children are common.

plasma vitamin C level and X-rays (e.g. may show fractures and dislocation; ground glass appearance of cortex, etc.)
Ascorbic acid is usually prescribed to build up the body's supply of vitamin C. Scurvy is fatal if untreated but patients generally respond quickly to oral therapy.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. eMedicine World Medical Library: http://www.emedicine.com/