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Case Reports: Unusual presentation of more common disease/injury
Scurvy: a rare cause of haemarthrosis
  1. Patrick Marquardt1,
  2. Ganesh Raman1,
  3. Yu-Min Shen1 and
  4. David H Wang1,2
  1. 1Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA
  2. 2VA North Texas Health Care System, Dallas, Texas, USA
  1. Correspondence to Dr David H Wang; david1.wang{at}utsouthwestern.edu

Abstract

A male in his 60s with a history of previously treated locally advanced head and neck cancer presented to the emergency department with atraumatic left knee pain and upper and lower extremity ecchymoses that had been present for 3 weeks. His initial laboratory results showed a normocytic anaemia, normal platelet count, slightly abnormal coagulation studies and normal inflammatory markers. Arthrocentesis of the left knee revealed haemarthrosis, and additional laboratory workup found an undetectable serum vitamin C (ascorbic acid) level consistent with scurvy. It was determined that scurvy had predisposed the patient to injury, leading to haemarthrosis. Following vitamin C supplementation, dietary and activity modifications, and acetaminophen as needed, the patient’s serum vitamin C level normalised and his left knee pain and swelling improved. Scurvy is a rare cause of haemarthrosis, but it should be recognised in at-risk patients since treatment is effective.

  • vitamins and supplements
  • knee injuries
  • connective tissue disease

https://doi.org/10.1136/bcr-2021-244594

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    Footnotes

    • Contributors PM, GR, Y-MS and DHW were responsible for study concept. PM and GR were responsible for writing of the manuscript. Interpretation of data was done by PM, GR, Y-MS and DHW. PM, GR, Y-MS and DHW performed revising for intellectual content. Final approval was given by PM, GR, Y-MS and DHW.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.