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Rheumatic manifestations of scurvy: a report of three recent cases in a major urban center and a review.
Semin Arthritis Rheum 2011; 41(2):286-90SA

Abstract

OBJECTIVES

To report 3 cases of scurvy seen in a large urban medical center over a 6-month period, referred for evaluation of rheumatologic symptoms and findings in the presence of elevated inflammatory markers. The relevant literature is reviewed and unusual manifestations highlighted.

METHODS

Descriptive case reports of 3 patients ultimately diagnosed with scurvy and a review of the relevant literature with an emphasis on rheumatologic manifestations (PubMed search, 1965 through August 2009).

RESULTS

Three patients presented with symptoms including fatigue, purpuric rash, synovitis with effusion, anemia, and markedly elevated erythrocyte sedimentation rate and C-reactive protein levels. One patient presented with severe pulmonary hypertension. Careful nutritional history revealed a diet deficient in vitamin C. Examination revealed hemarthrosis, skin findings characteristic of scurvy, and deficiency in vitamin C on laboratory analysis. Symptoms resolved with vitamin C supplementation. Characteristics and frequency of rheumatologic manifestations are reviewed.

CONCLUSIONS

While scurvy is usually described in poorer countries, individuals who have psychiatric disorders, or alcoholics with poor nutrition, it can occur even in otherwise normal populations in affluent countries. Such patients often present to rheumatologists with rheumatologic symptoms and awareness of the disease is necessary to make the proper diagnosis.

Authors+Show Affiliations

Division of Rheumatology, University of Minnesota Medical School, Minneapolis, MN, USA.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

21185063

Citation

Mertens, Marty T., and Elie Gertner. "Rheumatic Manifestations of Scurvy: a Report of Three Recent Cases in a Major Urban Center and a Review." Seminars in Arthritis and Rheumatism, vol. 41, no. 2, 2011, pp. 286-90.
Mertens MT, Gertner E. Rheumatic manifestations of scurvy: a report of three recent cases in a major urban center and a review. Semin Arthritis Rheum. 2011;41(2):286-90.
Mertens, M. T., & Gertner, E. (2011). Rheumatic manifestations of scurvy: a report of three recent cases in a major urban center and a review. Seminars in Arthritis and Rheumatism, 41(2), pp. 286-90. doi:10.1016/j.semarthrit.2010.10.005.
Mertens MT, Gertner E. Rheumatic Manifestations of Scurvy: a Report of Three Recent Cases in a Major Urban Center and a Review. Semin Arthritis Rheum. 2011;41(2):286-90. PubMed PMID: 21185063.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rheumatic manifestations of scurvy: a report of three recent cases in a major urban center and a review. AU - Mertens,Marty T, AU - Gertner,Elie, Y1 - 2010/12/23/ PY - 2010/07/22/received PY - 2010/10/20/revised PY - 2010/10/27/accepted PY - 2010/12/28/entrez PY - 2010/12/28/pubmed PY - 2012/2/18/medline SP - 286 EP - 90 JF - Seminars in arthritis and rheumatism JO - Semin. Arthritis Rheum. VL - 41 IS - 2 N2 - OBJECTIVES: To report 3 cases of scurvy seen in a large urban medical center over a 6-month period, referred for evaluation of rheumatologic symptoms and findings in the presence of elevated inflammatory markers. The relevant literature is reviewed and unusual manifestations highlighted. METHODS: Descriptive case reports of 3 patients ultimately diagnosed with scurvy and a review of the relevant literature with an emphasis on rheumatologic manifestations (PubMed search, 1965 through August 2009). RESULTS: Three patients presented with symptoms including fatigue, purpuric rash, synovitis with effusion, anemia, and markedly elevated erythrocyte sedimentation rate and C-reactive protein levels. One patient presented with severe pulmonary hypertension. Careful nutritional history revealed a diet deficient in vitamin C. Examination revealed hemarthrosis, skin findings characteristic of scurvy, and deficiency in vitamin C on laboratory analysis. Symptoms resolved with vitamin C supplementation. Characteristics and frequency of rheumatologic manifestations are reviewed. CONCLUSIONS: While scurvy is usually described in poorer countries, individuals who have psychiatric disorders, or alcoholics with poor nutrition, it can occur even in otherwise normal populations in affluent countries. Such patients often present to rheumatologists with rheumatologic symptoms and awareness of the disease is necessary to make the proper diagnosis. SN - 1532-866X UR - https://www.unboundmedicine.com/medline/citation/21185063/Rheumatic_manifestations_of_scurvy:_a_report_of_three_recent_cases_in_a_major_urban_center_and_a_review_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0049-0172(10)00233-7 DB - PRIME DP - Unbound Medicine ER -