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Query: UMLS:C0024523 (malabsorption)
 7,319 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

With a normal and varied food intake, the vitamin supply is often sufficient to avoid vitamin deficiency. Since synthetic vitamins have become available, it has become possible to take with one dose the amount of vitamins normally taken up from food in one year. In these pharmacological doses vitamins must therefore be considered as drugs. And in pharmacological doses, their actions are often different and not directly linked to their physiological activity. Two types of pathologic state are unquestionably the concern of vitaminotherapy: More or less specific and intense vitamin deficiencies: Rickets, scurvy, beri beri, pellagra, vitamin deficiency related to alcohol consumption, polyneuritis, encephalopathy, malabsorption, mucoviscidosis, etc. Genetic defects of vitamin metabolism: Prescriptions for these cases represent only a tiny part of the vitamin pharmaceutic market. The prescription of vitamins as adjuvants in other pathologic states without vitamin deficiency, such as neurological pains, psychosis, prevention of common cold, alopecia, anemia, asthenia, carpal tunnel defect, etc., is frequent. The results may be good; however, in some cases, the efficacy is due to chance or placebo effect, and there is no scientific or experimental evidence of beneficial activity. At the moment, the pharmacological vitamin research is very active. New products with vitamin-like structures are being synthesized for specialized therapeutic applications. They will in the near future probably replace elevated and mega-doses for clinical prescription, except, of course, for the treatment of vitamin deficiency. On the other hand, the use of multivitamin preparations in nutritional dosage will greatly increase.
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PMID:Clinical conditions requiring elevated dosages of vitamins. 250 93

Mucocutaneous changes occur in vitamin deficiency states and may be helpful in clinical diagnosis of the underlying disease. Substitution and therapy with vitamins can also cause skin problems, which may be of allergic of nonallergic origin. The skin and mucosal changes in pellagra and scurvy can be diagnostic; however, in other vitamin deficiencies, skin signs are rather unspecific. In most cases combined vitamin deficiencies occur that result in polymorphic and nonspecific mucocutaneous signs. Vitamin deficiencies are due to malnutrition, malabsorption or genetic defects. In industrialized countries alcoholism and gastrointestinal disorders are the main cause of vitamin deficiencies. Alcoholics or patients with malabsorption syndrome suffering from seborrheic dermatitis-like or ichthyosiform-like eruptions should be investigated for vitamin deficiency. Laboratory analysis of blood and urine vitamin levels can be misleading because of the poor correlation with tissue vitamin concentrations. Rapid clinical improvement following vitamin substitution frequently confirms the clinical diagnosis. In this overview we describe mucocutaneous signs of vitamin deficiencies. Excellent reviews of this topic are recommended for further reading [1-5].
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PMID:[Vitamins and skin]. 807 86

The pattern of fruit juice consumption has changed over time. Fifty years ago, orange juice was the major juice produced and it was consumed primarily to prevent scurvy. Now, apple juice is the juice of choice for the under 5 age group. While fruit juice is a healthy, low-fat, nutritious beverage, there have been some health concerns regarding juice consumption. Nursing bottle caries have long been recognized as a consequence of feeding juice in bottles, using the bottle as a pacifier, and prolonged bottle feeding. Non-specific chronic diarrhea or "toddler's" diarrhea has been associated with juice consumption, especially juices high in sorbitol and those with a high fructose to glucose ratio. This relates to carbohydrate malabsorption, which varies by the type, concentration, and mixture of sugars present in different fruit juices. Fruit juice consumption by preschoolers has recently increased from 3.2 to about 5.5 fl oz/day. Consumption of fruit juice helps fulfill the recommendation to eat more fruits and vegetables, with fruit juice accounting for 50% of all fruit servings consumed by children, aged 2 through 18 years, and 1/3 of all fruits and vegetables consumed by preschoolers. Concomitant with the increase in fruit juice consumption has been a decline in milk intake. This is concerning as milk is the major source of calcium in the diet, and at present, only 50% of children, aged 1 through 5 years, meet the RDA for calcium. Studies of newborn infants and preschool-aged children have demonstrated a preference for sweet-tasting foods and beverages. Thus, it is not surprising that some children, if given the opportunity, might consume more fruit juice than is considered optimal. Eleven percent of healthy preschoolers consumed > or = 12 fl oz/day of fruit juice, which is considered excessive. Excess fruit juice consumption has been reported as a contributing factor in some children with nonorganic failure to thrive and in some children with decreased stature. In other children, excessive fruit juice consumption has been associated with an increased caloric intake and obesity. This paper reviews the role of fruit juice in the diets of infants and children and outlines areas for future research. Recommendations regarding fruit juice consumption based on current data are also given.
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PMID:Fruit juice consumption by infants and children: a review. 889 77

Scurvy is a well-known disease of vitamin C deficiency that still occurs in industrialized countries. The clinical manifestations of follicular hyperkeratosis, perifollicular petechiae, corkscrew hairs, and easy bruising are due to defective collagen synthesis and can be mistaken for small vessel vasculitis. Populations at risk for development of scurvy include elderly patients, alcohol and drug users, individuals who follow restrictive diets or have eating disorders, patients with malabsorption, and individuals with mental illness. We report an acute case of scurvy presenting in the inpatient/hospital setting with clinical findings initially thought to represent vasculitis. A high index of suspicion for scurvy must be kept in the appropriate clinical context, and a thorough medical history and physical examination are vital to make the diagnosis.
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PMID:Acute inpatient presentation of scurvy. 2114 Sep 30

One of the most frequent questions gastroenterologists are asked about is diet, health, and disease; and some of the questions gastroenterologists are least comfortable answering are about diet, health, and disease. This disconnect occurs for several reasons. Although the subject of nutrition is taught in medical school, it usually covers malabsorption of nutrients, vitamins, and minerals that have limited relevance to the concerns of most patients. The modern physician does not see many cases of scurvy or beri beri. Physicians make decisions and recommendations from evidence-based medicine. Unfortunately, there is a dearth of sound data on diet and gastrointestinal diseases, forcing physicians to operate outside their comfort zone.
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PMID:Dietary dilemmas, delusions, and decisions. 2405 82

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.
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PMID:Severe scurvy: an underestimated disease. 2608 92

A 45-year-old man presented with follicular exanthema in his lower limbs, alternating bowel habits and significant weight loss. His medical history included seronegative arthritis, bipolar disease and an inconclusive diagnostic laparoscopy. Diagnostic work up revealed microcytic anaemia and multivitamin deficiency. Skin biopsy of the exanthema suggested scurvy. Owing to these signs of malabsorption, upper endoscopy with duodenal biopsies was performed, exhibiting villous atrophy and extensive periodic acid-Schiff-positive material in the lamina propria, therefore diagnosing Whipple's disease (WD). After starting treatment with ceftriaxone and co-trimoxazole, an impressive recovery was noted, as the wide spectrum of malabsorption signs quickly disappeared. After a year of antibiotics, articular and cutaneous manifestations improved, allowing the patient to stop taking corticosteroids and antidepressants. This truly unusual presentation reflects the multisystemic nature of WD, often leading to misdiagnosis of other entities. Scurvy is a rare finding in developed countries, but its presence should raise suspicion for small bowel disease.
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PMID:From past sailors' eras to the present day: scurvy as a surprising manifestation of an uncommon gastrointestinal disease. 2637 99

This paper presents the first bioarchaeological evidence of probable scurvy in Southeast Asia from a six-year-old child at the historic-era site of Phnom Khnang Peung (15-17th centuries A.D.) in the Cardamom Mountains, Cambodia. Examination of skeletal material shows evidence consistent with scurvy - specifically, abnormal porosity on the greater wings of the sphenoid bone and hard palate, and vascular impressions on the ectocranial surface of the frontal bone and maxillary alveolar bone. In addition, this individual has evidence of cribra orbitalia indicative of anemia. Although a nutritionally linked etiology is the most common cause of scurvy, a number of other factors influencing ascorbic acid levels need to be considered in an environment with sufficient vitamin C potentially available in the diet. Assessing the environmental evidence, the possibility of a number of interrelated factors contributing to the development of scurvy in this individual seems the most plausible explanation. Factors affecting vitamin C levels may have included social aspects of food allocation or choice of food, genetic predisposition, anemia, pathogens, and nutrient malabsorption.
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PMID:First bioarchaeological evidence of probable scurvy in Southeast Asia: Multifactorial etiologies of vitamin C deficiency in a tropical environment. 2953 69

Scurvy, caused by vitamin C deficiency, is very rare nowadays in the developed world. Scattered cases are found in people with unusual eating habits, alcoholism, intestinal malabsorption, mental disorders, or elderly living alone. Because of its rarity, clinical presentations of scurvy, especially anemia and bleeding, are no longer well appreciated, and consequently extensive evaluation is commonly launched to pursue scurvy mimics, such as deep vein thrombosis, vasculitis, systemic coagulation disorders, and myelodysplasia. Herein, we describe the clinical manifestations and lab findings in a scurvy patient to raise awareness of this uncommon disease.
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PMID:Behind the Skin: A Rare Case of Scurvy-Associated Megaloblastic Anemia. 3120 33

We present a case of an otherwise healthy 3-year-old child who presented with limping, bone pain, fatigue, and agitation. Differential diagnosis included an infection of the bone, malignancy, an inflammatory bone disease, and metabolic bone disease. Magnetic resonance imaging of the lower limbs and the spine was consistent with scurvy, and the diagnosis was confirmed by very low levels of vitamin C. Further history taking revealed a diet based entirely on dairy pudding, with no fruits or vegetables, and being a "picky eater" was the sole reason. Intravenous treatment with vitamin C led to full recovery. Previous reports of scurvy were in patients with other medical conditions, such as malabsorption, or behavioral conditions as in autism. This case demonstrates that scurvy, an almost forgotten condition from past centuries, can occur in otherwise healthy children and should raise awareness regarding the importance of a balanced diet and proper nutritional history taking. Following growth charts as the only screening tool for balanced and inclusive nutrition may not be sufficient.
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PMID:"What can you C in a limping child?" Scurvy in an otherwise healthy "picky eater". 3310 52


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