The term scurvy might conjure images of pirates or 18th century sailors. But the condition, caused by a vitamin C deficiency, often triggered by a poor diet, might actually be re-emerging.
A group of doctors in Australia described a middle-aged man who showed signs of scurvy in a study published in BMJ Case Reports. The man, who had recently undergone a bariatric weight loss surgery, had a rash that covered his legs with small red-brown pinpoints which continued to spread during his hospital stint. Doctors also detected blood in his urine, and diagnosed him with anemia. Tests for inflammatory, autoimmune, and blood disorders came up negative. There was no evidence of internal bleeding, and his skin biopsy was also normal.
After further inquiry, the researchers discovered the man had been eating poorly. He had neglected fruits and vegetables and skipped some meals altogether. He also said he couldn’t afford to continue to take nutritional supplements that had been prescribed after his weight loss surgery.
The doctors ran additional blood tests and saw that he had no vitamin C in his bloodstream, and also had very low levels of other key nutrients. They treated him with daily vitamin C (1000 mg), vitamin D3, folic acid, and multivitamin supplements. Soon after, his rash and other symptoms disappeared.
The case report shows that while scurvy is indeed a rare disease today, it is still possible to develop the condition. The authors note various risk factors for scurvy in today’s times including poor access to affordable, quality food and bariatric surgery, which can prevent nutrient absorption. Other conditions the authors cited include alcoholism, smoking, eating disorders, low household income, obesity, kidney dialysis, and taking drugs that interfere with vitamin C absorption, such as proton pump inhibitors, which treat acid reflux.
“Our patient had multiple risk factors, namely, poor dietary habits, obesity, previous bariatric surgery, use of proton pump inhibitors, and low-income status,” the authors write. “His history of iron, vitamin D, and folate deficiencies were also clues to his underlying nutritional deficiency.”
While scurvy is treatable — as seen with this case report — it is often misdiagnosed because it’s seen as a thing of the past. Scurvy can present as early as a month after becoming vitamin C deficient. Thus, efficient treatment is crucial.
“Failure to treat may lead to catastrophic hemorrhage, hence, early recognition and prompt treatment are vital,” the authors write.
