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[Scurvy. A rare differential diagnosis of rheumatic diseases]
K Hofheinz1, I Ganzleben2, S Schliep3
1Universitätsklinik für Innere Medizin 3, Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Deutschland. Katharina.hofheinz@uk-erlangen.de.
Insights
Scurvy, a rare vitamin C deficiency, can mimic rheumatic diseases like vasculitis and arthritis. Prompt diagnosis and ascorbic acid treatment are crucial when standard therapies fail.
Area of Science:
- Rheumatology
- Nutritional Science
- Internal Medicine
Background:
- A patient presented with vasculitis symptoms unresponsive to glucocorticoids.
- Extended differential diagnostics led to a scurvy diagnosis.
Observation:
- Scurvy presents as a rare hypovitaminosis with diverse clinical manifestations.
- Symptoms can mimic vasculitis, arthritis, and hemarthrosis.
- Unspecific symptoms include myalgia; impaired collagen synthesis causes corkscrew hair.
Findings:
- Scurvy is a differential diagnosis for rheumatic conditions.
- Lack of response to immunosuppressants may indicate scurvy.
- Characteristic symptoms like corkscrew hair aid diagnosis.
Implications:
- Scurvy should be considered in rheumatology patients with atypical presentations.
- Ascorbic acid substitution is the definitive treatment for scurvy.
- Recognizing scurvy improves patient outcomes by enabling targeted therapy.
Background:
In December 2014 a patient presented to our clinic with the clinical symptoms of vasculitis. However, treatment with glucocorticoids did not lead to any improvement; therefore, the differential diagnostics were extended to other indications and ultimately led to the diagnosis of scurvy.
Objective:
This article describes the clinical picture of scurvy and its relationship to rheumatic diseases based on a clinical case and additional information from the literature. Differences and similarities with important rheumatological disease symptoms are presented.
Results:
Scurvy is a rare hypovitaminosis disease which can be manifested in different forms. In addition to vasculitis the symptoms can also resemble arthritis and hemarthrosis is a typical finding. These symptoms can be accompanied by unspecific manifestations, such as muscle pain and due to impaired collagen synthesis characteristic features, such as corkscrew hair can be observed. The causal therapy of scurvy is substitution of ascorbic acid.
Conclusion:
Scurvy is a rare differential diagnosis in the context of rheumatic diseases. The indications for scurvy can be a lack of response to immunosuppressive and immunomodulatory drugs as well as individual symptoms, such as corkscrew hair.
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