Scurvy, resulting from vitamin C deficiency, has nonspecific constitutional symptoms, including weakness, malaise, and fatigue. It is frequently misdiagnosed due to the lack of specific clinical manifestations. Although there are sporadic cases of scurvy currently reported in children, scurvy in young people is seldom encountered. Here, we report on a 25-year-old male patient without any underlying conditions who presented with severe pain and ecchymoses of both lower extremities. He was diagnosed with scurvy due to a long history of staying indoors and inadequate intake of fruits or vegetables.

Fully integrated nanodevices that allow the complete functional implementation without an external accessory or equipment are deemed to be one of the most ideal and ultimate goals for modern nanodevice design and construction. In this work, we demonstrate the first example of a bendable biofuel cell (BFC)-based fully integrated biomedical nanodevice with simple, palm-sized, easy-to-carry, pump-free, cost-saving, and easy-to-use features for the point-of-care (POC) diagnosis of scurvy from a single drop of untreated human serum (down to 0.2 μL) by integrating a bendable and disposable vitamin C/air microfluidic BFC (micro-BFC) (named iezCard) for self-powered vitamin C biosensing with a custom mini digital LED voltmeter (named iezBox) for signal processing and transmission, along with a ″built-in″ biocomputing BUFFER gate for intelligent diagnosis. Under the simplicity- and practicability-oriented idea, a cost-effective strategy (e.g., biomass-derived hierarchical micro-mesoporous carbon aerogels, screen-printed technique, a single piece of Kimwipes paper, LED display, and universal components) was implemented for nanodevice design rather than any top-end or pricey method (e.g., photolithography/electron-beam evaporation, peristaltic pump, wireless system, and 3D printing technique), which enormously reduces the cost of feedstock down to ∼USD 2.55 per integrated kit including a disposal iezCard (∼USD 0.08 per test) and a reusable iezBox (∼USD 2.47 for large-scale tests). These distinctive and attractive features allow such a fully integrated biomedical nanodevice to fully satisfy the basic requirements for POC diagnosis of scurvy from a single drop of raw human serum and make it particularly appropriate for resource-poor settings, where there is a lack of medical facilities, funds, and qualified personnel.

Endocranial lesions were recognized on eight out of the 31 juveniles (25.8%) that were recovered from three Neolithic archaeological sites in Henan province. The remains of juveniles were recovered from urn burials at the Jiazhuang site (2200-2030 BCE) and graves at the Pingliangtai (2300-2100 BCE) and Haojiatai sites (2448-1700 BCE). The presence of endocranial lesions on all eight of these juvenile skulls was associated with a range of lesions on other bones, including areas of abnormal porosity and subperiosteal new bone deposition on either the sphenoid, maxilla, mandibular ramus, or orbit, as well as subperiosteal lesions on the postcranial bones. Several plausible explanations for the formation of these endocranial lesions in our eight cases include scurvy, shaken baby syndrome, and intrathoracic disease (such as tuberculosis or pulmonary infection). We show that the presence of endocranial lesions had a strong correspondence with skeletal markers of dietary deficiency, i.e. scurvy, and in one case, anemia. Millet was a key component of the Longshan subsistence in the area, while paleobotanical evidence of fruit and leafy vegetables appears to be limited, likely resulting in a nutrient deficient diet. The coupling of endocranial lesions with skeletal signs of dietary deficiency can be direct, as scurvy favors hemorrhaging, or mediated by physiological or sociocultural factors, and thereby represents comorbidity.

Vitamin C deficiency may be common in third-world countries due to malnutrition, but it is currently rare in the USA. Initially, nonspecific symptoms like exhaustion and depression may make this disease difficult to diagnose until classical dermatological manifestations appear. Diagnosis mainly relies on clinical presentation, dietary history to identify risk factors, and dramatic recession of symptoms and signs following vitamin C therapy. Human beings cannot synthesize vitamin C and hence need 90% of vitamin C intake from fruits and vegetables. As a processed carbohydrate-rich diet becomes the staple food, scurvy must be recognized before it becomes potentially fatal. We describe a 65-year-old man with dyspnea, fatigue, anemia, and bleeding diathesis from scurvy and emphasize the importance of dietary history and the critical role of vitamin C in diagnosis and management of this forgotten entity.