Image7Symptoms and signs of scurvy may be remembered by the 4 Hs: hemorrhage, hyperkeratosis, hypochondriasis, and hematologic abnormalities.

The initial symptoms of scurvy are nonspecific and include the following:

  • Malaise
  • Lethargy
  • Loss of appetite
  • Peevishness (ill-tempered)
  • Poor weight gain
  • Diarrhea
  • Tachypnea
  • Fever

After 1-3 months of severe or total vitamin C deficiency, patients develop shortness of breath and bone pain. Myalgias may occur because of reduced carnitine production. Skin changes with roughness, easy bruising and petechiae, gum disease, loosening of teeth, poor wound healing, and emotional changes occur. Dry mouth and dry eyes similar to Sjögren syndrome may occur.

Other symptoms include the following:

  • Irritability
  • Pain and tenderness of the legs
  • Pseudoparalysis
  • Swelling over the long bones
  • Hemorrhage

In the late stages, jaundice, generalized edema, oliguria, neuropathy, fever, and convulsions can be seen. Left untreated scurvy progresses, with potentially fatal complications, including cerebral hemorrhage or hemopericardium.