Vitamin C Deficiency Related Cytopenias in Hematology Practice: Revisiting Risk Factors of Access and Income

Area of Science:

• Hematology
• Nutritional Science
• Public Health

Background:

• Vitamin C (l-ascorbic acid) is vital for iron absorption, collagen synthesis, and immune function.
• Severe vitamin C deficiency is a potentially overlooked cause of hematologic abnormalities.

Purpose of the Study:

• To analyze the clinical presentation and outcomes of patients with severe vitamin C deficiency in a hematology clinic.
• To identify factors contributing to vitamin C deficiency and its impact on hematologic parameters.

Main Methods:

• Retrospective analysis of 23 patients with severe vitamin C deficiency ( < 0.1 mg/dL) from 2020-2025.
• Examination of patient demographics, clinical findings, laboratory values, and treatment responses.
• Principal component analysis of laboratory data to identify phenotypic clusters.

Main Results:

• Most patients presented with anemia, fatigue, or dermatologic issues; over half resided in food deserts.
• Overlapping micronutrient deficiencies were common; 17% underwent bone marrow biopsy.
• Socioeconomic status was a major factor influencing laboratory data variability, followed by cell counts.

Conclusions:

• Severe vitamin C deficiency is a contemporary and reversible cause of cytopenias in hematology.
• Successful treatment and normalization of blood counts were observed with follow-up and vitamin C level normalization.
• Dietary and socioeconomic risk assessment is essential in the diagnostic evaluation of hematologic conditions.