Environmental And Nutritional Diseases
Write a short note on scurvy.
Or
Discuss in short scurvy.
Or
Write in brief on vitamin C deficiency.
Answer:
Vitamin C deficiency in the food or as conditioned deficiency results in scurvy.
The lesions and clinical manifestations are seen more commonly in two ages, i.e. early childhood and very aged.
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The lesions are:
1. Lesions in teeth and gums: Scurvy may interfere with the development of dentin. The gums are soft, and swollen and may bleed readily and get infected commonly. The gums are called scorbutic gums.
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2. Hemorrhagic diathesis: A marked tendency to bleed is characteristic of scurvy. There may be hemorrhages of skin, mucus membranes, gums, muscles, joints, and under the periosteum.
3. Skeletal lesions: The most prominent change is the deranged formation of osteoid matrix and not deranged mineralization. Growing tubular bones and as well as flat bones are affected.
4. Delayed wound healing: There is a delay in healing wounds in scurvy due to:
- Deranged collagen synthesis
- Poor maturation and prevention of fibroblasts.
- Localization of infection in wounds.
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5. Anemia: It is common in scurvy. It is most often Normocytic and Normochromic.
Scurvy Histopathology
The following are the histologic features of scurvy:
- In scurvy, osteoblasts fail to form osteoid on spicules of calcified cartilage matrix.
- Cartilage cells of the epiphyseal plate proliferate normally and salts are deposited in the matrix between columns of cartilage cells.
- A wide zone of calcified but non-ossified matrix known as scorbutic lattice develops in the metaphysics.
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- As the scorbutic lattice increases in width more fragile zone develops which leads to a complete fracture of spicules with separation and deformity of the cartilage shaft junction.
- Fractures of calcified matrix material lead to the classic picture of scurvy known as the Trummerfeld zone.
- The area beneath the Trummerfeld zone is free of hematopoietic cells and is formed of connective tissue cells known as Gemestmark.
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