ascorbic-acid and Anorexia-Nervosa

Topics: Aged; Alkaline Phosphatase; Anorexia Nervosa; Ascorbic Acid; Eating; England; Feeding Behavior; Humans; Niacinamide; Nutrition Disorders; Nutritional Physiological Phenomena; Osteomalacia; Placebos; Pyridoxine; Riboflavin; Scotland; Thiamine; Vitamins

Vitamin C deficiency results in the clinical presentation of scurvy, a disease that is rare among the adolescent population. Individuals with unusual dietary habits, mental illness, or physical disability are more prone to develop scurvy. We present a case report of a previously healthy 16-year-old female presented to the hospital with a 12-month history of anorexia nervosa, restrictive subtype. She was admitted to the intensive care unit and transferred to a tertiary care pediatric eating disorder program for the treatment of extreme weight loss, cardiovascular instability, and refeeding syndrome. On examination, she had multiple tiny hyperpigmented perifollicular petechial papules on the lower abdomen, dorsum thighs, and extensor surfaces of the arms with corkscrew hairs on the abdomen. Dermatologic examination and laboratory investigations were consistent with a diagnosis of scurvy. The patient's vitamin C serum level was 21 μmol/L (.23 mg/dL; reference range 25-114 μmol/L [.28-1.28 mg/dL]). She was treated with ascorbic acid orally. Objective cutaneous findings improved within 4 weeks of supplementation, and after 6 weeks, repeat levels of vitamin C levels were 102 μmol/L (1.15 mg/dL). To the best of our knowledge, this is the first case of an adolescent female with anorexia nervosa and cutaneous manifestations of scurvy that resolved after the oral administration of vitamin C.

Topics: Adolescent; Anorexia Nervosa; Ascorbic Acid; Feeding Behavior; Female; Humans; Scurvy; Vitamins

Scurvy is a nutritional disease caused by ascorbic acid deficiency and is potentially fatal. It was originally described in the 18th century by James Lind and associated with long sea voyages and insufficient citrus consumption. Its prevalence has declined markedly over the years but has still been described sporadically in certain countries. A 22-year-old woman with an anxiety disorder and anorexia nervosa, recent pregnancy and ongoing breast feeding, presented with a 10-day history of spontaneous haematomas in the lower limbs, gingivorrhagia and fatigue. The examination was remarkable for signs of minor bleeding without haemodynamic compromise, gonalgia and pale skin. Work-up studies revealed the presence of anaemia. Direct anamnesis identified a diet based solely of tea and carbohydrates due to distorted body image. With the working diagnosis of scurvy, nutritional support and oral vitamin C supplementation was initiated. Her symptoms and anaemia resolved in 30 days and the diagnosis was confirmed biochemically.

Topics: Adult; Anemia; Anorexia Nervosa; Anxiety Disorders; Ascorbic Acid; Breast Feeding; Diagnosis, Differential; Diet; Dietary Carbohydrates; Dietary Supplements; Fatigue; Female; Gingival Hemorrhage; Hematoma; Humans; Scurvy; Tea; Young Adult

Scurvy, or "Barlow's disease", is a widely described disease involving cutaneous and mucosal lesions resulting from vitamin C deficiency. Herein, we report a case of scurvy in a 48-year-old woman that was unusual in its atypical cutaneous-mucosal presentation as well as its association with anorexia nervosa.. A 48-year-old woman treated for depression for several years was admitted to hospital for her impaired general state of health. Over the last year, she had presented palmoplantar rash and episodes of perimalleolar oedema. The clinical examination showed the patient to have wasting syndrome, with a BMI of 11.9kg/m. The absence of classical buccal-dental symptoms and the presence of keratotic dermatosis with fissures and ulcers on the hands and feet are atypical in scurvy; however, this diagnosis was confirmed by the existence of purpura evoking capillary fragility, the patient's drastically low vitamin C level and the rapid subsidence of symptoms following treatment with oral vitamin C alone. Anorexia nervosa was doubtless the cause of deficiency. This situation is rare and a systematic review of the literature in Medline via PubMed showed that only three reports of scurvy associated with mental anorexia have been published since 1975.

Topics: Anorexia Nervosa; Ascorbic Acid; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Middle Aged; Scurvy; Wasting Syndrome

Scurvy is one of the oldest diseases in human history. Nowadays, although scurvy tends to become a forgotten disease in developed country, rare cases still occur, especially in people undergoing extreme diet, old people or children with poor diet and patients with malabsorption. We describe three cases of scurvy. The first case is a patient diagnosed with Crohn's disease, the second one is in a context of anorexia nervosa and drug addiction, and the third case is in a context of social isolation. Early recognition of scurvy can be difficult because symptoms may appear nonspecific and can mimic more common conditions. In any patient with spontaneous hematoma and purpura, in the context of nutritional disorder, scurvy should be systematically considered. As this disease can lead to severe complications, such as bone pain, heart failure or gastrointestinal symptoms, nothing should delay vitamin C supplementation, which is a simple and rapidly effective treatment.

Topics: Adult; Anorexia Nervosa; Ascorbic Acid; Crohn Disease; Dietary Supplements; Female; Humans; Male; Middle Aged; Scurvy; Social Isolation; Substance-Related Disorders; Vitamins

Scurvy is an extremely rare complication of anorexia nervosa. Despite the poor intake of nutrients, anorexia nervosa is not commonly associated with vitamin deficiencies. We report a case of early scurvy complicating long-standing anorexia nervosa. Anorexia nervosa appears to be increasing in incidence. Although scurvy is unusual, this case shows the importance of its recognition as a nutritional consequence of anorexia nervosa.

Topics: Anorexia Nervosa; Ascorbic Acid; Female; Humans; Middle Aged; Scurvy

A retrospective study of typical 24-h food intake was undertaken of the diets of 17 anorexia nervosa patients during the initial and the most severe phases of their illness. Patients completed a nutritional knowledge questionnaire. Patients' diets were significantly lower in energy and in all major nutrients than those of control subjects. The proportion of energy derived from protein was significantly higher, from fats significantly lower and from carbohydrates not significantly different from that of controls. The mean intake of all nutrients in the more severe phase of illness was lower in the initial phase. Intakes of calcium, retinol activity and ascorbic acid were below RDA levels in the majority of patients, but only a few reported intakes of thiamin, riboflavin and niacin equivalent below RDA values. Most patients scored higher on the nutritional knowledge questionnaire than matched controls, particularly in respect to questions concerning caloric content of food, dieting and roughage. Not all patients obtained high nutritional knowledge scores however, and 25 per cent performed less well than selected controls.

Topics: Adolescent; Adult; Anorexia Nervosa; Ascorbic Acid; Cognition; Diet; Dietary Proteins; Energy Intake; Female; Humans; Iron; Nutritional Physiological Phenomena; Nutritional Requirements; Vitamin B Complex

Topics: Adult; Aged; Anorexia Nervosa; Ascorbic Acid; Asthenia; Dyspepsia; Feeding and Eating Disorders; Female; Humans; Male; Middle Aged; Phosphatidylcholines

Topics: Aged; Anorexia Nervosa; Ascorbic Acid; Asthenia; Betaine; Cinnamates; Dyspepsia; Female; Humans; Male; Middle Aged; Phosphatidylcholines

Topics: Alcoholism; Anemia; Anemia, Macrocytic; Anorexia Nervosa; Ascorbic Acid; Avitaminosis; Celiac Disease; Deficiency Diseases; Diet; Diet Therapy; Female; Folic Acid; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Pregnancy; Pregnancy Complications; Sprue, Tropical; United Kingdom; Vitamin A; Vitamin B 12; Vitamin B Complex; Vitamin D; Vitamin K; Vitamins; Vomiting