Scurvy is still present in developed countries

Bertha Velandia, Robert M Centor, Vicky McConnell, Mobin Shah
Journal of General Internal Medicine 2008, 23 (8): 1281-4

INTRODUCTION: Scurvy, while uncommon, still occurs in developed countries despite the widespread availability of vitamins and fortified foods. A vitamin C deficiency prevalence of 10 to 14% in adults was reported in the National Health and Nutrition Examination Survey (NHANES) in 1994.

OBJECTIVE: We report the case of a 57-year-old male who presented with a combined vitamin C deficiency (scurvy) and a Zinc deficiency.

INTERVENTIONS: He came to the emergency department complaining of a painful swollen ecchymotic leg and dyspnea. Prescriptions for narcotics did not relieve his symptoms. When a detailed dietary history was obtained, we added scurvy to the differential diagnosis. An extensive evaluation excluded trauma, coagulopathies, neoplasia, and vasculitides.

MAIN RESULT: The combination of a classic skin biopsy and a low vitamin C level confirmed the diagnosis.

CONCLUSION: This presentation illustrates the necessity of including scurvy in the differential diagnosis of ecchymoses and demonstrates specific populations at risk: single adults and the elderly with deficient diets.

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