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Vitamin C Deficiency in an Anticoagulated Patient

  • Clinical Practice: Clinical Vignettes
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ABSTRACT

A 64-year-old woman presented with a hemorrhagic perifollicular rash on her legs while taking warfarin. After biopsy, vitamin C deficiency was suggested as the diagnosis, which ascorbic acid assays later confirmed. Clinical resolution of the rash followed supplementation with vitamin C. Patients on a vitamin K limited diet may also be limiting their intake of vitamin C. Physicians should be aware of this possible correlation, and consider checking vitamin C levels in patients with a perifollicular hemorrhagic rash or other signs of vitamin C deficiency while on warfarin.

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Acknowledgements

This case was presented as a poster at the West Virginia Geriatric Society meeting, September 2011, and at the West Virginia American College of Physicians meeting, October 2011. The picture of the rash is online at http://emedicine.medscape.com/article/125350-overview and Dr. Goebel holds the copyright.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Authors and Affiliations

  1. Joan C. Edwards School of Medicine, Marshall University, 1249 15th St, Huntington, WV, 25701, USA

    George M. Yousef MD & Lynne J. Goebel MD, FACP

Authors
  1. George M. Yousef MD
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  2. Lynne J. Goebel MD, FACP
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Correspondence to Lynne J. Goebel MD, FACP.

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Yousef, G.M., Goebel, L.J. Vitamin C Deficiency in an Anticoagulated Patient. J GEN INTERN MED 28, 852–854 (2013). https://doi.org/10.1007/s11606-012-2282-3

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  • DOI: https://doi.org/10.1007/s11606-012-2282-3

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