Department of Dermatology, Georgetown University, Washington Cancer Institute, Washington, DC 20010, USA.
Clin Exp Dermatol. 2009 Oct;34(7):811-4. doi: 10.1111/j.1365-2230.2008.03052.x. Epub 2009 Dec 15.
The association of vitamin C deficiency with nutritional factors is commonly recognized. However, an acute form of scurvy can occur in patients with an acute systemic inflammatory response, which is produced by sepsis, medications, cancer or acute inflammation. The frequency of acute hypovitaminosis C in hospitalized patients is higher than previously recognized. We report the occurrence of acute signs and symptoms of scurvy (perifollicular petechiae, erythema, gingivitis and bleeding) in a patient hospitalized for treatment of metastatic renal-cell carcinoma with high-dose interleukin-2. Concomitantly, serum vitamin C levels decreased to below normal. Better diets and longer lifespan may result a lower frequency of acute scurvy and a higher frequency of scurvy associated with systemic inflammatory responses. Therefore, increased awareness of this condition can lead to early recognition of the cutaneous signs of acute scurvy in hospitalized patients with acute illnesses or in receipt of biological agents, and prevent subsequent morbidity such as bleeding, anaemia, impaired immune defences, oedema or neurological symptoms.
维生素 C 缺乏与营养因素有关，这是大家普遍认可的。然而，在发生败血症、药物、癌症或急性炎症等全身炎症反应时，也可能出现急性坏血病。在住院患者中，急性维生素 C 缺乏的频率比以前认识到的要高。我们报告了一例转移性肾细胞癌患者在接受高剂量白细胞介素-2 治疗时发生急性坏血病的体征和症状（毛囊周围瘀点、红斑、牙龈炎和出血）。同时，血清维生素 C 水平降至正常值以下。更好的饮食和更长的寿命可能会导致急性坏血病的频率降低，而与全身炎症反应相关的坏血病的频率增加。因此，提高对这种情况的认识可以导致早期识别患有急性疾病或正在接受生物制剂治疗的住院患者的急性坏血病的皮肤体征，并预防随后出现出血、贫血、免疫防御受损、水肿或神经症状等并发症。
