Diagnosis is mainly made by history and physical findings. Serum ascorbic acid level may help establish the diagnosis, but this tends to reflect recent dietary intake rather than actual tissue levels of vitamin C. Signs of scurvy can occur with low-normal serum levels of vitamin C. Leukocyte ascorbate levels reveal tissue stores of vitamin C more accurately than do serum levels, but the test is technically difficult to perform and is not readily available. Urinary ascorbic acid levels may be measured. The earliest radiologic manifestation of infantile scurvy is generally seen at the distal ends of the radii where there is fuzziness of the lateral aspect of the cortices with slight rarefaction of the neighboring cancellous bone. Noninflammatory perivascular extravasation of red cells and deposition of hemosiderin near hair follicles with intrafollicular keratotic plugs and coiled hair may be seen on biopsy.
Most sources recommend that scurvy be treated with ascorbic acid.
Patients who undergo dialysis should receive 500 mg of supplemental vitamin C daily. Patients will also benefit from a daily multivitamin because of potential coexisting nutritional deficiencies. Patients and their families should be educated about proper nutrition. The goal of treatment of scurvy is to saturate the body quickly with ascorbic acid. At maximum doses, body stores become saturated in a few days.