Summary
Definition
History and exam
Key diagnostic factors
- deficiência de vitamina C após a revisão alimentar
- sintomas constitucionais
- facilidade para manifestar hematomas ou sangramento
- comprometimento da marcha ou dor na perna
- edema nos pés
- hemorragias petequiais e perifoliculares (pernas e pés)
- cicatrização deficiente de feridas
- hematomas e equimoses nodulares ou negras em locais não traumáticos
- edema na articulação
- petéquias na mucosa oral
- cabelos enrolados
- hiperceratose folicular
- perda de dentes
- descoloração gengival
- edema da gengiva
- petéquias e hemorragias na pálpebra
- proptose
- hemorragia conjuntival e subconjuntival
Other diagnostic factors
- disfagia
- alopécia
- síndrome semelhante à seca ou de Sjögren
- baqueteamento digital ungueal
- neuropatia periférica (encarceramento)
- acidente vascular cerebral
- insuficiência cardíaca
- derrame pleural hemorrágico
- osteoporose
Risk factors
- populações de refugiados e afetadas pela fome
- síndrome do desconforto respiratório agudo
- idosos
- morar sozinho
- transtornos psiquiátricos
- transtornos decorrentes do uso de bebidas alcoólicas
- demência
- baixa renda
- dietas da moda
- má dentição ou ineficiência mastigatória
- transtorno do espectro autista
- encefalopatias estáticas da infância
- lactentes que tomam apenas leite de vaca
- doença renal em estágio terminal, dependência de hemodiálise, e/ou pós-transplante renal
- tabagismo
- cirurgia
- sepse
- vírus da imunodeficiência humana (HIV)
- doença crítica
- pancreatite
- doença inflamatória intestinal (DII)
- doença do enxerto contra o hospedeiro (DECH)
Diagnostic tests
1st tests to order
- hemograma completo e esfregaço de sangue periférico
- ácido ascórbico sérico
- ácido ascórbico leucocitário
- ácido ascórbico no sangue total
- radiografia do joelho e punho
Tests to consider
- ressonância nuclear magnética (RNM) do joelho, punhos e ossos longos em casos pediátricos
- biópsia da medula óssea
Treatment algorithm
alto risco ou população sintomática
Contributors
Authors
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
Disclosures
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
Disclosures
AAS has been paid consultancy fees with Edwards Lifesciences and PCCM board review. AAS is a course editor with American Physician Institute.
Acknowledgements
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.
Disclosures
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.
Peer reviewers
Mark R. Corkins, MD
Professor of Pediatrics
University of Tennessee Health Science Center
Le Bonheur Children’s Hospital
Memphis
TN
Disclosures
MRC declares that he has no competing interests.
References
Key articles
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.Full text
National Institutes of Health. Vitamin C: fact sheet for health professionals. Mar 2021 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Vasculite sistêmica
- Neoplasia hematológica
- Meningococcemia
More DifferentialsGuidelines
- Nutrition and growth refugee healthy domestic guidance
- 2020-2025 dietary guidelines for Americans
More Guidelines
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