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Vitamin C Deficiency as a Mimicker of a Coagulation Disorder
  1. Kanika Ajay Malani1 and
  2. Jill O'Brien1,2
  1. 1Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
  2. 2Division of Medicine, Miriam Hospital, Providence, RI, USA
  1. Correspondence to Kanika Ajay Malani; kanika_malani{at}brown.edu

Abstract

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.

  • Haematology (drugs and medicines)
  • Nutrition
  • Diet
  • Malnutrition
  • Pulmonary embolism

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: KAM and JOB. The following authors gave final approval of the manuscript: KAM and JOB.

  • 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.