Masuda Yohei, Saigusa Kuniyasu, Norisue Yasuhiro
Department of Emergency and Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, JPN.
Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, JPN.
Cureus. 2024 Feb 23;16(2):e54777. doi: 10.7759/cureus.54777. eCollection 2024 Feb.
Vitamin C deficiency, also known as scurvy, causes abnormalities in connective tissues and varied symptoms. We describe a patient with putaminal hemorrhage, a very rare presentation of scurvy. A 39-year-old man presented with weakness in the left arm and left leg. Right putaminal hemorrhage was initially diagnosed, and he underwent evacuation of the intracerebral hemorrhage. Scurvy was suspected when repeated physical examinations revealed a bleeding tendency and multiple untreated dental caries, missing teeth, and gingivitis. A diagnosis of scurvy was further supported by the patient's history of smoking, alcohol use disorder, poor diet, and low plasma vitamin C concentration. After receiving oral nutritional supplementation including vitamin C, the bleeding tendency quickly improved. This case highlights the importance of including scurvy in a differential diagnosis for patients with bleeding tendencies, especially those with a poor diet or unknown dietary history. Empirical administration of vitamin C is a reasonable treatment.
维生素C缺乏症，也称为坏血病，会导致结缔组织异常和各种症状。我们描述了一名患有壳核出血的患者，这是坏血病非常罕见的一种表现形式。一名39岁男性出现左臂和左腿无力症状。最初诊断为右侧壳核出血，随后他接受了脑出血清除手术。当反复体格检查发现有出血倾向以及多处未经治疗的龋齿、牙齿缺失和牙龈炎时，怀疑患有坏血病。患者的吸烟史、酒精使用障碍、不良饮食习惯以及低血浆维生素C浓度进一步支持了坏血病的诊断。在接受包括维生素C在内的口服营养补充后，出血倾向迅速改善。该病例强调了在对有出血倾向的患者，尤其是饮食不良或饮食史不明的患者进行鉴别诊断时，将坏血病纳入考虑的重要性。经验性给予维生素C是一种合理的治疗方法。
