Recurrent subcutaneous hemorrhage and leg weakness: A case of scurvy presenting as simple Purpura

Although uncommon, scurvy can still occur in developed contries and can cause substantial morbidity and be life threatening if untreated. An impoverished 68-year-old woman with a low intake of fruit and vegetables presented with weakness and painful purpura on both legs, having experienced a similar episode 3 years previously. Laboratory tests revealed anemia, coagulopathy, a low folic acid concentration, and serum vitamin C concentration below the limit of detection. She was admitted and treated with transfusions of packed red blood cells and fresh frozen plasma owing to the coagulopathy, and vitamin C and folic acid were administered to correct the micronutrient deficiencies. Her clinical condition improved within a few days, and she was discharged ambulatory on hospital day 14. Clinicians should maintain a high index of suspicion for scurvy in patients with unexplained purpura and social risk factors.