Thomas Jason M, Burtson Kathryn M
Internal Medicine, Wright Patterson Air Force Base/Wright State University, Dayton, USA.
Cureus. 2021 Apr 5;13(4):e14312. doi: 10.7759/cureus.14312.
Scurvy is a rare disease which can manifest in a variety of presentations. Classically, scurvy is associated with poor dentition and bleeding diatheses. Rarely, scurvy can present with life-threatening hemodynamical instability. Herein, we report the case of a 69-year-old female with a history of hypertension and depression who presented with four months of weakness and a 20-pound weight loss. Her presentation was complicated by lower extremity bruising and myalgias over the last three weeks. The patient's blood pressure in the emergency department was 86/54 mmHg. On further examination, she had poor dentition and extensive ecchymoses in different stages of resolution over her posterior thighs and calves. The patient was also noted to have perifollicular hemorrhages. An ascorbic acid level was checked and the result was 0.0 mg/dL (normal range: 0.4 to 2.0 mg/dL). During her admission, she slowly improved with a provided diet and multivitamins. Her blood pressure consistently remained over 120/65 mmHg. The patient was advised to adjust her diet and take supplemental ascorbic acid. On a follow-up visit two weeks later, the patient endorsed an improvement in pain and exercise tolerance and was noted to have marked improvement in skin findings. Ascorbic acid is an essential piece of multiple biochemical pathways. Humans are required to attain ascorbic acid from their diet. People who consume diets lacking in ascorbic acid develop scurvy.
坏血病是一种罕见疾病，可表现为多种症状。典型情况下，坏血病与牙齿发育不良和出血倾向有关。坏血病很少会出现危及生命的血流动力学不稳定。在此，我们报告一例69岁女性病例，她有高血压和抑郁症病史，出现了四个月的虚弱症状，体重减轻了20磅。在过去三周里，她的症状因下肢瘀伤和肌痛而变得复杂。患者在急诊科的血压为86/54 mmHg。进一步检查发现，她牙齿发育不良，大腿后侧和小腿有不同程度的广泛瘀斑，处于消退的不同阶段。还注意到患者有毛囊周围出血。检查了抗坏血酸水平，结果为0.0 mg/dL（正常范围：0.4至2.0 mg/dL）。在她住院期间，通过提供的饮食和多种维生素，她的情况逐渐好转。她的血压一直保持在120/65 mmHg以上。建议患者调整饮食并补充抗坏血酸。两周后的随访中，患者表示疼痛和运动耐量有所改善，皮肤症状也有明显改善。抗坏血酸是多种生化途径的重要组成部分。人类需要从饮食中获取抗坏血酸。饮食中缺乏抗坏血酸的人会患坏血病。
