Scurvy's Systemic Clinical Picture: A Multiorgan Presentation of a Conspicuous Disease

A man whose diet was limited to consumption of chicken, fish, and bread was admitted for weight loss, dyspnea, and cutaneous lesions. Findings of the physical examination included lower-extremity purpura. Initial work-up demonstrated severe ferropenic anemia, hyperbilirubinemia, vertebral fracture,...

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Main Authors: Daniel Alberto Carrillo-Vázquez, Alejandro Gutierrez-Castillo, Carlos Antonio Davizon-López, Alejandro Barrera-Godínez, María Graciela Leal-Gutiérrez, Marcela Saeb-Lima
Format: Article
Language:English
Published: American College of Physicians 2023-01-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2022.0746
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Summary:A man whose diet was limited to consumption of chicken, fish, and bread was admitted for weight loss, dyspnea, and cutaneous lesions. Findings of the physical examination included lower-extremity purpura. Initial work-up demonstrated severe ferropenic anemia, hyperbilirubinemia, vertebral fracture, and dilation of the inferior vena cava and right cardiac chambers. Vitamin C deficiency was documented and, after adequate supplementation, the anemia, hyperbilirubinemia, and bleeding resolved. This case demonstrates the wide, unspecific, and reversible systemic manifestations associated with scurvy, its potential as a great mimicker, and the relevance of nutritional deficiencies even in an apparently nutrient-rich environment.
ISSN:2767-7664