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Now you see/C it
Alexander E Domingo1, Christopher B Ruser1,2, Brittany Simone1,3
1a Yale University School of Medicine , New Haven , CT , USA.
Insights
Scurvy, a vitamin C deficiency, can cause spontaneous bleeding and is often overlooked. Recognizing risk factors and classic signs like gum bleeding can lead to earlier diagnosis and treatment of this vascular integrity disorder.
Area of Science:
- Internal Medicine
- Hematology
- Nutrition
Background:
- Bleeding disorders are common and necessitate a broad differential diagnosis.
- Clinicians must consider vascular integrity disorders alongside platelet and clotting factor abnormalities.
Observation:
- A patient presented with unusual, spontaneous bleeding episodes.
- The bleeding was ultimately attributed to scurvy, a frequently missed diagnosis.
Findings:
- Scurvy, caused by vitamin C deficiency, presents with classic signs such as gingival bleeding, bruising, corkscrew hairs, and poor wound healing.
- Risk factors include poor diet, male gender, smoking, and alcohol abuse.
Implications:
- Heightened clinical awareness of scurvy is crucial for timely diagnosis.
- Early identification and treatment of scurvy can prevent complications associated with bleeding disorders.
Abstract:
Bleeding disorders are common. In addition to thinking about disorders relating to abnormal platelets or clotting factors, clinicians should consider disorders of vascular integrity in their differential diagnosis. We present a patient with atypical, spontaneous bleeding that was due to scurvy, an often overlooked cause. Clinicians should be aware of the risk factors for the development of scurvy, such as poor dietary intake, male gender, smoking, alcohol abuse, as well as its classic manifestations, including gingival bleeding, spontaneous bruising, corkscrew hairs, and poor wound healing, A heightened awareness may lead to earlier diagnosis and treatment.