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Scurvy in a 56-year-old man caused knee bleeding and swelling due to poor diet. Electron microscopy revealed collagen synthesis defects in the synovial membrane, which resolved with nutritional therapy.
Area of Science:
- Rheumatology
- Nutritional Science
- Cell Biology
Background:
- Scurvy, a condition caused by vitamin C deficiency, can manifest with diverse symptoms.
- Joint effusions and bleeding diatheses are known, but synovial changes are less documented.
- This case explores the joint manifestations of scurvy in an adult.
Observation:
- A 56-year-old male presented with knee hemarthroses and synovial thickening attributed to poor dietary intake.
- Synovial membrane biopsy revealed interstitial hemorrhage, enlarged fibroblasts, and minimal collagen.
- Electron microscopy showed disarray of the vascular basement membrane.
Findings:
- The study provides the first electron-microscopic analysis of human scurvy affecting the synovial membrane.
- Findings indicate a significant defect in collagen synthesis.
- Resolution of hemarthroses and symptoms occurred following dietary correction.
Implications:
- This case highlights collagen synthesis defects as a key factor in the joint pathology of scurvy.
- It underscores the importance of nutritional assessment in patients with unexplained joint bleeding.
- The findings contribute to understanding the cellular mechanisms underlying vitamin C deficiency-related connective tissue disorders.
Abstract:
Scurvy developed in a 56-year-old man with poor dietary intake and was associated with knee hemarthroses and synovial thickening. The synovial membrane showed interstitial hemorrhage and many large fibroblasts but little collagen and some disarray of vascular basement membrane. Hemarthroses and all knee symptoms completely resolved on a normal diet. To our knowledge, these are the first electron-microscopic studies of synovial membrane in human scurvy, and our findings support a defect in collagen synthesis as a factor in etiology.