ICD-10: E54

Ascorbic acid deficiency, commonly known as scurvy, is a condition resulting from insufficient vitamin C intake. This deficiency can lead to a range of clinical presentations, signs, symptoms, and patient characteristics that are important for diagnosis and management.

Clinical Presentation

The clinical presentation of ascorbic acid deficiency can vary widely, but it typically includes a combination of systemic and localized symptoms. The onset of symptoms may be gradual, often developing over several weeks to months, particularly in individuals with chronic dietary insufficiency.

Common Signs and Symptoms

1. Fatigue and Weakness: Patients often report general fatigue and a lack of energy, which can be attributed to the role of vitamin C in collagen synthesis and overall metabolic processes[1].

2. Gum Disease: One of the hallmark signs of scurvy is gingivitis, characterized by swollen, bleeding gums. This occurs due to the breakdown of collagen in the gum tissue[2].

3. Skin Changes: Patients may exhibit petechiae (small red or purple spots) and ecchymosis (bruising) due to capillary fragility. The skin may also become rough and dry, and hair may become coiled or corkscrew-shaped[3].

4. Joint Pain and Swelling: Ascorbic acid deficiency can lead to joint pain, particularly in the knees and elbows, due to inflammation and bleeding into the joints[4].

5. Anemia: Vitamin C is essential for iron absorption; thus, deficiency can lead to iron-deficiency anemia, presenting with symptoms such as pallor and shortness of breath[5].

6. Delayed Wound Healing: Patients may experience prolonged healing times for cuts and wounds, as vitamin C is crucial for collagen formation and tissue repair[6].

7. Mood Changes: Some individuals may experience mood disturbances, including irritability and depression, which can be linked to the physiological effects of vitamin C on neurotransmitter synthesis[7].

Additional Symptoms

• Bone Pain: In severe cases, patients may experience bone pain due to the weakening of collagen in bone tissue[8].
• Swollen Joints: Inflammation can lead to swollen joints, particularly in the extremities[9].

Patient Characteristics

Certain patient populations are more susceptible to ascorbic acid deficiency:

1. Dietary Insufficiency: Individuals with limited access to fresh fruits and vegetables, such as those living in food deserts or with restrictive diets, are at higher risk[10].

2. Chronic Illness: Patients with chronic diseases, such as cancer or gastrointestinal disorders, may have increased nutritional needs or malabsorption issues that predispose them to deficiency[11].

3. Elderly Individuals: Older adults may have decreased dietary intake and absorption, making them more vulnerable to vitamin C deficiency[12].

4. Substance Abuse: Individuals with alcohol or drug dependence may neglect their nutritional needs, leading to deficiencies[13].

5. Smoking: Smokers have higher vitamin C requirements due to oxidative stress and may not meet these needs through diet alone[14].

Conclusion

Ascorbic acid deficiency, or scurvy, presents with a variety of clinical signs and symptoms, including fatigue, gum disease, skin changes, joint pain, and delayed wound healing. Understanding the patient characteristics that contribute to this deficiency is crucial for effective diagnosis and treatment. Early recognition and dietary intervention can prevent the progression of symptoms and improve patient outcomes. If you suspect a patient may be suffering from ascorbic acid deficiency, a thorough dietary assessment and appropriate supplementation should be considered.

Ascorbic acid deficiency, classified under ICD-10 code E54, refers to a condition resulting from insufficient levels of vitamin C in the body. This deficiency can lead to a variety of health issues, primarily affecting the skin, blood vessels, and connective tissues.

Clinical Description

Definition

Ascorbic acid, commonly known as vitamin C, is a water-soluble vitamin essential for various bodily functions, including the synthesis of collagen, the absorption of iron, and the maintenance of the immune system. A deficiency in this vitamin can lead to scurvy, a disease characterized by symptoms such as fatigue, weakness, and anemia, as well as more severe manifestations like bleeding gums, joint pain, and skin issues[1][2].

Symptoms

The clinical manifestations of ascorbic acid deficiency can vary but typically include:

• Fatigue and Weakness: Early signs often include general fatigue and weakness due to the body's inability to produce collagen effectively.
• Gingival Changes: Swollen, bleeding gums are a hallmark of vitamin C deficiency, as collagen is crucial for maintaining healthy gum tissue.
• Skin Issues: The skin may become rough, dry, and scaly, and there may be easy bruising due to weakened blood vessels.
• Joint Pain: Patients may experience joint pain and swelling, which can be attributed to the breakdown of collagen in connective tissues.
• Anemia: Vitamin C is important for iron absorption; thus, deficiency can lead to iron-deficiency anemia, characterized by fatigue and pallor[3][4].

Risk Factors

Certain populations are at higher risk for developing ascorbic acid deficiency, including:

• Individuals with Poor Dietary Intake: Those who do not consume sufficient fruits and vegetables are at risk, particularly in diets low in fresh produce.
• Chronic Illness: Conditions such as diabetes, cancer, and chronic inflammatory diseases can increase the body's demand for vitamin C.
• Alcoholism: Excessive alcohol consumption can impair the absorption of nutrients, including vitamin C.
• Smoking: Smokers have a higher requirement for vitamin C due to increased oxidative stress and metabolic turnover[5][6].

Diagnosis

Diagnosis of ascorbic acid deficiency typically involves a combination of clinical evaluation and laboratory tests. A healthcare provider may assess dietary intake, review symptoms, and conduct blood tests to measure plasma levels of vitamin C. A low level of ascorbic acid in the blood confirms the deficiency[7].

Treatment

The primary treatment for ascorbic acid deficiency is dietary supplementation. Increasing the intake of vitamin C-rich foods, such as citrus fruits, strawberries, kiwi, bell peppers, and broccoli, is recommended. In more severe cases, oral or intravenous vitamin C supplements may be prescribed to rapidly restore adequate levels[8].

Conclusion

Ascorbic acid deficiency (E54) is a preventable condition that can lead to significant health issues if left untreated. Awareness of dietary sources of vitamin C and the symptoms of deficiency is crucial for early detection and management. Regular monitoring and dietary adjustments can effectively prevent and treat this deficiency, ensuring optimal health and well-being.

References

1. ICD-10-CM Code for Ascorbic acid deficiency E54.
2. ICD-10 Version: 2016.
3. ICD-10-CM/PCS MS-DRG v37.2 Definitions Manual.
4. ICD-10 Codes covered under Medical Nutrition Therapy.
5. ICD-10-CM TABULAR LIST of DISEASES and INJURIES.
6. ICD 10 AM Complications Codes and Descriptors.
7. ICD-10-AM Disease Code List.
8. ICD-10-CM TABULAR LIST of DISEASES and INJURIES.

Ascorbic acid deficiency, commonly known as vitamin C deficiency, is classified under the ICD-10 code E54. This condition can lead to a variety of health issues, most notably scurvy, which is characterized by symptoms such as fatigue, swollen gums, joint pain, and anemia. Below are alternative names and related terms associated with ICD-10 code E54.

Alternative Names for Ascorbic Acid Deficiency

1. Vitamin C Deficiency: This is the most widely recognized term for ascorbic acid deficiency, emphasizing the vitamin's role in health.
2. Scurvy: A historical term that refers specifically to the severe manifestations of vitamin C deficiency, including bleeding gums and skin issues.
3. Hypovitaminosis C: A medical term that indicates a deficiency of vitamin C in the body.
4. Ascorbate Deficiency: This term highlights the lack of ascorbate, the ionized form of ascorbic acid, in the body.

Related Terms

1. Antioxidant Deficiency: Since vitamin C is a potent antioxidant, its deficiency can be related to broader discussions about antioxidant levels in the body.
2. Nutritional Deficiency: Ascorbic acid deficiency falls under the category of nutritional deficiencies, which can encompass a range of vitamin and mineral shortages.
3. Dietary Deficiency: This term refers to the lack of essential nutrients in the diet, including vitamin C.
4. Scurvy Symptoms: This phrase encompasses the clinical manifestations associated with severe vitamin C deficiency, such as fatigue, joint pain, and skin changes.

Conclusion

Understanding the various names and related terms for ascorbic acid deficiency can aid in better communication regarding the condition, whether in clinical settings or educational contexts. Recognizing these terms is essential for healthcare professionals, researchers, and individuals seeking to understand the implications of vitamin C deficiency on health.

The ICD-10 code E54 refers specifically to ascorbic acid deficiency, commonly known as vitamin C deficiency. This condition can lead to scurvy, a disease characterized by various symptoms due to the lack of vitamin C, which is essential for collagen synthesis, immune function, and overall health. The diagnosis of ascorbic acid deficiency typically involves several criteria, which can be categorized into clinical, biochemical, and dietary assessments.

Clinical Criteria

1. Symptoms of Scurvy: The presence of clinical symptoms is a primary criterion for diagnosing vitamin C deficiency. Common symptoms include:
   - Fatigue and weakness
   - Swollen and bleeding gums
   - Joint pain and swelling
   - Anemia
   - Skin changes, such as easy bruising and poor wound healing
   - Corkscrew hairs

2. Patient History: A thorough medical history is essential. This includes:
   - Dietary habits, particularly the intake of fruits and vegetables rich in vitamin C.
   - Any underlying conditions that may affect nutrient absorption, such as gastrointestinal disorders.

Biochemical Criteria

1. Plasma Ascorbic Acid Levels: The most definitive biochemical test for diagnosing vitamin C deficiency is measuring plasma ascorbic acid levels. Normal levels typically range from 0.6 to 2.0 mg/dL. Levels below 0.2 mg/dL are indicative of deficiency.

2. Urinary Excretion: Assessing the amount of vitamin C excreted in urine can also provide insights. Low levels of ascorbic acid in urine may suggest inadequate dietary intake.

Dietary Assessment

1. Dietary Intake Evaluation: A dietary assessment can help determine if the patient is consuming adequate amounts of vitamin C. The recommended daily allowance (RDA) for vitamin C varies by age and sex but is generally around 75 mg for adult women and 90 mg for adult men.

2. Food Frequency Questionnaires: These tools can help assess the frequency of consumption of vitamin C-rich foods, such as citrus fruits, strawberries, bell peppers, and broccoli.

Conclusion

In summary, the diagnosis of ascorbic acid deficiency (ICD-10 code E54) relies on a combination of clinical symptoms, biochemical tests measuring plasma ascorbic acid levels, and dietary assessments. Early diagnosis and treatment are crucial to prevent complications associated with vitamin C deficiency, such as scurvy. If you suspect a deficiency, it is advisable to consult a healthcare professional for appropriate testing and management.

Ascorbic acid deficiency, commonly known as vitamin C deficiency, is classified under the ICD-10 code E54. This condition can lead to a range of health issues, including scurvy, which is characterized by symptoms such as fatigue, swollen gums, joint pain, and anemia. Understanding the standard treatment approaches for this deficiency is crucial for effective management and recovery.

Understanding Ascorbic Acid Deficiency

Vitamin C is an essential nutrient that plays a vital role in various bodily functions, including collagen synthesis, antioxidant protection, and immune function. A deficiency can occur due to inadequate dietary intake, malabsorption issues, or increased physiological demands, such as during pregnancy or illness[1].

Standard Treatment Approaches

1. Dietary Modification

The primary treatment for ascorbic acid deficiency is dietary intervention. Increasing the intake of vitamin C-rich foods is essential. Recommended sources include:

• Fruits: Oranges, strawberries, kiwi, guava, and papaya.
• Vegetables: Bell peppers, broccoli, Brussels sprouts, and spinach.

The recommended daily allowance (RDA) for vitamin C varies by age and gender, but generally, adults require about 65 to 90 mg per day, with an upper limit of 2,000 mg[2].

2. Vitamin C Supplementation

In cases where dietary intake is insufficient or when rapid correction of deficiency is needed, vitamin C supplements may be prescribed. These can be taken in various forms, including:

• Oral Supplements: Available as tablets, capsules, or powders. Doses can range from 100 mg to 1,000 mg daily, depending on the severity of the deficiency and individual health needs.
• Intravenous (IV) Vitamin C: In severe cases or when oral supplementation is not feasible, IV administration may be considered, particularly in hospitalized patients or those with malabsorption issues[3].

3. Monitoring and Follow-Up

Regular monitoring of vitamin C levels and clinical symptoms is important to assess the effectiveness of treatment. Healthcare providers may recommend follow-up appointments to evaluate dietary habits, supplement adherence, and symptom resolution. Blood tests can help determine vitamin C levels and ensure they return to normal ranges[4].

4. Addressing Underlying Causes

If the deficiency is due to underlying health issues, such as gastrointestinal disorders that impair absorption, these conditions must be addressed concurrently. This may involve:

• Medical Management: Treating conditions like Crohn's disease or ulcerative colitis that affect nutrient absorption.
• Nutritional Counseling: Working with a dietitian to develop a balanced diet that meets individual needs and addresses any specific health concerns[5].

Conclusion

Ascorbic acid deficiency is a manageable condition with appropriate dietary changes and supplementation. By increasing vitamin C intake through food and supplements, individuals can effectively combat deficiency and prevent associated health complications. Regular monitoring and addressing any underlying health issues are also crucial for long-term health and well-being. If you suspect a vitamin C deficiency, consulting a healthcare provider for personalized advice and treatment is recommended.