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重新审视坏血病的发病机制:结合一个挑战性病例对文献的回顾。

Revisiting the pathobiology of scurvy: a review of the literature in the context of a challenging case.

机构信息

Departments of Dermatology and Pathology, Wayne State University School of Medicine, Detroit, Michigan, USA.

出版信息

Int J Dermatol. 2020 Dec;59(12):1450-1457. doi: 10.1111/ijd.14832. Epub 2020 Mar 10.

Abstract

Scurvy is a nutritional disorder resulting from vitamin C deficiency. Although rare in developing countries, scurvy continues to develop in settings of limited dietary intake such as post-gastrointestinal surgery and restrictive dietary habits. The disease primarily affects the skin and soft tissue. As the state of deficiency persists, hematological and immunological sequelae may develop. The classic signs of scurvy are not always present and can be altered by the presence of other comorbidities. In this article, we present a challenging case of scurvy in an older male from an urban tertiary healthcare setting. We review the atypical and uncommon clinical and pathological findings of scurvy including those seen in the skin, blood, and bone marrow. We also review contemporary research findings that provide a better understanding of the pathogenicity and clinical manifestations of vitamin C deficiency.

摘要

坏血病是一种由于维生素 C 缺乏导致的营养性疾病。尽管在发展中国家较为少见,但在限制饮食摄入的环境下,如胃肠道手术后和限制饮食习惯,坏血病仍会发生。这种疾病主要影响皮肤和软组织。随着缺乏状态的持续,可能会出现血液学和免疫学的后遗症。经典的坏血病征象并不总是存在,并且可能会因其他合并症的存在而改变。在本文中,我们介绍了一个来自城市三级医疗保健环境的老年男性坏血病的挑战性病例。我们回顾了坏血病不典型和不常见的临床和病理表现,包括皮肤、血液和骨髓中的表现。我们还回顾了当代研究结果,这些结果更好地理解了维生素 C 缺乏的发病机制和临床表现。

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