Vieira Amanda A O, Minicucci Marcos Ferreira, Gaiolla Rafael D, Okoshi Marina P, Duarte Daniella R, Matsubara Luiz S, Inoue Roberto M T, Azevedo Paula S, Polegato Bertha F, Zornoff Leonardo A M, Paiva Sergio A R
Botucatu Medical School, Internal Medicine, Rubiao Jr s/n, Botucatu, 18618-000, Brazil.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.07.2008.0462. Epub 2009 Mar 20.
Historically, scurvy has been associated with sailors of great navigational epochs. This disease has been known since ancient Egypt, but nowadays it is almost forgotten. Although its prevalence has decreased over the centuries, scurvy is still present in developed countries. A 61-year-old man was referred to hospital with a 30-day history of anorexia, fatigue, gingival bleeding and ecchymosis of the arms and legs. On physical examination he presented gingival hypertrophic lesions, signs of chronic periodontitis and petechial rash, and several bruises on his arms and legs. A food frequency questionnaire revealed a long history of poor diet, with no vegetables or fruit. The patient had ingested only chocolate milk and cookies for the last 10 years due to fear of pesticides being present in foods of vegetable origin. A diagnosis of scurvy induced by obsessive-compulsive disorder was suspected, and after vitamin C supplementation there was a marked improvement of symptoms.
从历史上看，坏血病一直与伟大航海时代的水手们联系在一起。这种疾病自古埃及就已为人所知，但如今几乎已被遗忘。尽管几个世纪以来其发病率有所下降，但坏血病在发达国家仍然存在。一名61岁的男子因厌食、疲劳、牙龈出血以及手臂和腿部瘀斑30天的病史被转诊至医院。体格检查发现他有牙龈肥大性病变、慢性牙周炎体征和瘀点疹，手臂和腿部还有几处瘀伤。一份食物频率问卷显示其长期饮食不良，不吃蔬菜或水果。由于担心植物源性食物中存在农药，该患者在过去10年里只摄入巧克力牛奶和饼干。怀疑诊断为强迫症诱发的坏血病，补充维生素C后症状有明显改善。
