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J Gen Intern Med. 2008 Aug;23(8):1281-4. doi: 10.1007/s11606-008-0577-1. Epub 2008 May 6.

Scurvy is still present in developed countries.

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  • 1Department of Family Practice, University of Alabama, Huntsville, AL, USA.

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.

PMID:
18459013
[PubMed - indexed for MEDLINE]
PMCID:
PMC2517958
Free PMC Article

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