Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- vitamin C deficiency upon dietary review
- constitutional symptoms
- easy bruising or bleeding
- gait impairment or leg pain
- pedal edema
- petechial and perifollicular hemorrhages (legs and feet)
- poor wound healing
- bruising and nodular or black ecchymoses at nontraumatic sites
- joint swelling
- oral mucosal petechiae
- coiled hairs
- follicular hyperkeratosis
- tooth loss
- gingival discoloration
- gum swelling
- lid petechiae and hemorrhages
- proptosis
- conjunctival and subconjunctival hemorrhage
Outros fatores diagnósticos
- dysphagia
- alopecia
- sicca-like or Sjogren-like syndrome
- nail clubbing
- peripheral (entrapment) neuropathy
- cerebrovascular accident
- cardiac failure
- hemorrhagic pleural effusion
- osteoporosis
Fatores de risco
- famine and refugee populations
- acute respiratory distress syndrome
- older people
- living alone
- psychiatric disorders
- alcohol use disorder
- dementia
- low income
- atypical diets
- poor dentition or masticatory inefficiency
- autistic spectrum disorder
- static encephalopathies of childhood
- infants taking only cow's milk
- end stage renal disease, hemodialysis dependence, and/or postrenal transplant
- smoking
- surgery
- sepsis
- HIV
- critical illness
- pancreatitis
- inflammatory bowel disease (IBD)
- graft versus host disease (GVHD)
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- CBC and peripheral blood smear
- serum ascorbic acid
- leukocyte ascorbic acid
- whole blood ascorbic acid
- x-ray of knee and wrist
Investigações a serem consideradas
- MRI of knee, wrists, and long bones in pediatric cases
- bone marrow biopsy
Algoritmo de tratamento
high risk or symptomatic population
Colaboradores
Autores
Caleb P. Kitcho, MD
Clinical Assistant Professor of Pediatrics
Senior Pediatric Critical Care Medicine Fellow (PGY-6)
University of Wisconsin School of Medicine and Public Health
Department of Pediatrics
Madison
WI
Declarações
CK declares that he has no competing interests.
Awni Al-Subu, MD, FAAP
Associate Professor Pediatrics
University of Wisconsin School of Medicine and Public Health
Department of Pediatrics
Madison
WI
Declarações
AAS has been paid consultancy fees with Edwards Lifesciences and PCCM board review. AAS is a course editor with American Physician Institute.
Agradecimentos
Dr Awni Al-Subu and Dr Caleb P. Kitcho would like to gratefully acknowledge Dr James M. Noble and Dr Marc C. Patterson, previous contributors to this topic.
Declarações
JMN is an author of two articles cited in this topic. MCP is a member of the scientific advisory boards of the Ara Parseghian Medical Research Foundation, the National Niemann-Pick Disease Foundation, and the Metachromatic Leukodystrophy Foundation. MCP has been a consultant for Actelion, Amicus, IntraBio, Novartis, Orphazyme, Shire, and Vtesse. MCP has undertaken contractual research for Cerecor, Glycomine, Idorsia, and Shire. MCP has stock in IntraBio. MCP has received travel, accommodation or meeting expenses from Actelion, Amicus, Novartis, and Orphazyme.
Revisores
Mark R. Corkins, MD
Professor of Pediatrics
University of Tennessee Health Science Center
Le Bonheur Children’s Hospital
Memphis
TN
Declarações
MRC declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Centers for Disease Control and Prevention. Nutrition and growth: refugee health domestic guidance. May 2024 [internet publication].Texto completo
Dietary Guidelines for Americans. 2020-2025 dietary guidelines for Americans. Dec 2020 [internet publication].Texto completo
Gonzalez-Campoy JM, St Jeor ST, Castorino K, et al. Clinical practice guidelines for healthy eating for the prevention and treatment of metabolic and endocrine diseases in adults: cosponsored by the American Association of Clinical Endocrinologists/the American College of Endocrinology and the Obesity Society. Endocr Pract. 2013 Sep-Oct;19 Suppl 3:1-82.Texto completo
Panel on Dietary Antioxidants and Related Compounds, Subcommittees on Upper Reference Levels of Nutrients and Interpretation and Uses of DRIs, Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board, Institute of Medicine. Chapter 5: vitamin C. In: Food and Nutrition Board, Institute of Medicine’s Dietary reference intakes for vitamin C, vitamin E, selenium, and carotenoids. Washington DC: National Academy Press; 2000: 95-185.Texto completo Resumo
National Institutes of Health. Vitamin C: fact sheet for health professionals. Mar 2021 [internet publication].Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Systemic vasculitis
- Hematologic malignancy
- Meningococcemia
Mais Diagnósticos diferenciaisDiretrizes
- Nutrition and growth refugee healthy domestic guidance
- 2020-2025 dietary guidelines for Americans
Mais DiretrizesConectar-se ou assinar para acessar todo o BMJ Best Practice
O uso deste conteúdo está sujeito ao nosso aviso legal