Causes and risk factors
Scorbutic anemia refers to anemia caused in patients with scurvy. Scurvy is caused by vitamin C, [i.e., ascorbic acid] deficiency. Scorbutic anemia is megaloblastic type of anemia. There is deficiency of vitamin B12 and folic acid along with vitamin C. Megaloblastic anemia is a blood disorder characterized by presence of structurally large and immature blood cells called as megaloblasts. The megaloblasts found in scurvy patients is due to deficiency of folate. The diet taken by the scurvy patients also lacks folic acid. Also, there is an increased requirement of folic acid in scurvy patients, which when unfulfilled, leads to anemia. Hemorrhage and hemolysis in scurvy both lead to folate depletion.
Clinical presentation
The patients present with symptoms of scurvy as well as megaloblastic anemia. Patient shows loss of appetite, poor weight gain. There is presence of hemorrhages, bleeding gums, loose teeth, petechiae. Discomfort in legs, swelling over long bones is experienced. Subperiosteal hemorrhage [a specific bleeding that occurs at the lower ends of the long bones] can occur. Symptoms of megaloblastic anemia include change in skin color, pale skin color. There is sore mouth and tongue, loss of appetite, diarrhea. Patient complains of headaches, tiredness, and dizziness. There can be tingling and numbness of hands and feet, lack of co-ordination, or impaired memory.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. The tests include complete blood count, examination of blood smear, serum B12, serum folate, blood levels of iron and iron binding capacity, serum ascorbic acid [vitamin C].
Treatment
The treatment is focused on normalizing ascorbic acid levels. Vitamin C supplements will help treat scurvy. Folic acid supplements will also be required to treat megaloblastic anemia. Scurvy can be prevented by eating a diet rich in vitamin C such as citrus fruits like oranges, guavas, strawberries, bell peppers, etc.
Other Modes of treatment
The other modes of treatment can also be effective in treating scorbutic anemia. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating scorbutic anemia.
Facts and figures
World Health Organization studies suggest 10% to 20% of the population in the developing countries of the world suffers from nutritional anemia.
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