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Scurvy Is Still Present in Developed Countries

  • Bertha Velandia
  • Robert M. Centor
  • Vicky McConnell
  • Mobin Shah
Case Reports/Clinical Vignettes

Abstract

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.

KEY WORDS

scurvy 57-year-old male patient vitamin C developed country ecchymosis 

Notes

Acknowledgments

None.

Conflict of Interest

None disclosed.

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Copyright information

© Society of General Internal Medicine 2008

Authors and Affiliations

  • Bertha Velandia
    • 1
  • Robert M. Centor
    • 2
  • Vicky McConnell
    • 2
  • Mobin Shah
    • 1
  1. 1.Department of Family PracticeUniversity of AlabamaHuntsvilleUSA
  2. 2.Department of Internal MedicineUniversity of Alabama BirminghamBirminghamUSA

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