[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.
Abstract

Related Concept Videos

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
1.0K
Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
840
Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
487
Rheumatic Heart Disease IV: Nursing Management01:20

Rheumatic Heart Disease IV: Nursing Management

AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
450
Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
760
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
790