A Modern Day Case of Scurvy

Author(s): Batoul Sadek, DO, Mohamed Hashem, DO, Aasems Jacob, MD

Ascorbic acid (Vitamin C) is an essential dietary nutrient. Humans rely on exogenous sources of vitamin C as they are unable to produce their own. Vitamin C is utilized for many functions in the body. When humans are without Vitamin C for extended periods of time, they may develop scurvy. Symptoms of scurvy include follicular hyperkeratosis, ecchymoses, leg edema, gingival swelling, gum discoloration, oral hemorrhage, perifollicular hemorrhage, poor wound healing, and bent/ coiled body hairs. Most cases of scurvy are seen in the developing world where access to vitamin C containing food may be limited or in individuals with absorption issues. However, cases, while rare, still occur in developed countries. In this case study, we discuss a 61-yearold female who presented with easy bruising and fatigue and was later diagnosed with scurvy. This patient had undetectable levels of vitamin C. This case was unique for a variety of reasons. First, the patient's vitamin C levels remained undetectable despite being on a large dose oral supplementation of Vitamin C for an extended period of time. Additionally, the patient had isolated skin involvement. The patient did not experience typical manifestations of scurvy such as hemorrhage and mucosal involvement. We present this case given the rarity of scurvy in the United States and the unique presentation of this patient.

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