Severe scurvy in a patient with eosinophilicoesophagitis

BMJ Case Rep. 2019 Aug 26;12(8):e230800. doi: 10.1136/bcr-2019-230800.

Abstract

While scurvy is considered to be a rare disease in the modern era, the disease still presents in certain populations with nutritional deficiencies such as those with poor nutritional absorption secondary to gastrointestinal disorders and in patients with poor nutritional intake. We present a case of scurvy in a patient who had eosinophilic oesophagitis which limited his oral intake. He presented with the classic symptoms of scurvy including a perifollicular rash, arthralgia, gingivitis and anaemia. He was treated with intravenous vitamin C initially followed by an oral course after which he showed improvement. This case demonstrates that it is important to consider vitamin C deficiency in patients with who present with anaemia and bleeding stigmata specifically in those who have poor nutritional intake. Furthermore, additional consideration should be given to patients with malnutrition as part of the preoperative evaluation.

Keywords: diet; malnutrition; nutrition and metabolism; oesophagus; vitamins and supplements.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravenous
  • Anemia* / blood
  • Anemia* / diagnosis
  • Anemia* / etiology
  • Ascorbic Acid* / administration & dosage
  • Ascorbic Acid* / blood
  • Biopsy / methods
  • Diagnosis, Differential
  • Eosinophilic Esophagitis* / complications
  • Eosinophilic Esophagitis* / pathology
  • Eosinophilic Esophagitis* / physiopathology
  • Humans
  • Iron / blood
  • Physical Examination / methods
  • Scurvy* / diagnosis
  • Scurvy* / etiology
  • Scurvy* / physiopathology
  • Scurvy* / therapy
  • Severity of Illness Index
  • Skin / pathology
  • Treatment Outcome
  • Vitamins / administration & dosage
  • Vitamins / blood

Substances

  • Vitamins
  • Iron
  • Ascorbic Acid