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Acute scurvy during treatment with interleukin-2.

D T Alexandrescu¹, C A Dasanu, C L Kauffman

¹Department of Dermatology, Georgetown University, Washington Cancer Institute, Washington, DC 20010, USA. mddoru@hotmail.com

Clinical and Experimental Dermatology

|December 20, 2008

Summary

Acute scurvy can occur in hospitalized patients due to systemic inflammation, not just poor nutrition. Early recognition of skin signs is crucial for preventing complications like bleeding and anemia.

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Area of Science:

Clinical Medicine
Nutritional Science
Oncology

Background:

Vitamin C deficiency (hypovitaminosis C) is typically linked to nutritional deficits.
Acute scurvy, a severe form of vitamin C deficiency, can manifest during acute systemic inflammatory responses.

Observation:

Hospitalized patients, particularly those with sepsis, cancer, or undergoing treatment with biological agents like interleukin-2, may present with acute hypovitaminosis C.
A case report details acute scurvy signs (petechiae, gingivitis, bleeding) in a patient treated for metastatic renal-cell carcinoma.

Findings:

Serum vitamin C levels were noted to decrease significantly in the observed patient.
The frequency of acute hypovitaminosis C in hospitalized individuals appears underestimated.

Implications:

Increased awareness of acute scurvy's presentation is vital for early diagnosis in hospitalized patients with acute illnesses or receiving specific treatments.
Prompt recognition can prevent severe complications, including bleeding, anemia, impaired immunity, edema, and neurological symptoms.