Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
BMJ Case Rep. 2024 Feb 27;17(2):e259310. doi: 10.1136/bcr-2023-259310.
Scurvy is caused by vitamin C deficiency and is often thought of as an ancient malady. However, it still afflicts present-day patients with insufficient nutrition, excessive alcohol consumption and disorders of absorption. Scurvy is traditionally characterised by ecchymosis, petechiae, haemorrhages, poor wound healing, myalgias and arthralgias, but it can also present with non-specific symptoms, including mood changes, fatigue, malaise and dyspnoea. Although scurvy can present with signs of excess bleeding, it does not involve blood clotting. We present a case of concurrent scurvy and pulmonary embolism in which clinical presentation and laboratory findings mimicked a coagulation disorder, resulting in delayed diagnosis and excessive resource expenditure. This case underscores the importance of obtaining an early dietary and substance use history in patients with unexplained haematological symptoms. These crucial components of history-taking can significantly reduce invasive and costly tests, resulting in quicker diagnosis and enhanced patient outcomes.
坏血病是由维生素 C 缺乏引起的,通常被认为是一种古老的疾病。然而,它仍然困扰着现今营养不足、过度饮酒和吸收障碍的患者。坏血病的传统特征是瘀斑、瘀点、出血、伤口愈合不良、肌痛和关节痛,但也可能出现非特异性症状,包括情绪变化、疲劳、不适和呼吸困难。虽然坏血病可能出现出血过多的迹象,但它并不涉及血液凝结。我们报告了一例并发坏血病和肺栓塞的病例,其临床表现和实验室检查结果类似于凝血障碍,导致诊断延迟和过度资源消耗。这个病例强调了在出现不明原因血液症状的患者中获取早期饮食和物质使用史的重要性。这些病史的关键组成部分可以显著减少侵入性和昂贵的检查,从而更快地诊断和改善患者的预后。