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A rare presentation of an ancient disease: scurvy presenting as orthostatic hypotension.
BMJ Case Rep. 2014 May 23; 2014BC

Abstract

A 49-year-old man presented to hospital with severe orthostatic hypotension, gingival dysplasia and a purpuric rash involving his extremities. The orthostatic hypotension failed to respond to fluids and, on the basis of physical examination and dietary history, the patient was given a preliminary diagnosis of scurvy (ascorbic acid deficiency). Serum ascorbic acid levels were undetectable and the orthostasis was resolved within 24 h of ascorbic acid replacement. The pathogenesis of orthostatic hypotension in the setting of scurvy appears to involve impaired catecholamine synthesis and attenuated vasomotor response to α-adrenergic stimulation. We believe that this case describes a rare presentation of scurvy and highlights a previously under-reported connection between scurvy and vasomotor instability.

Authors+Show Affiliations

Department of Internal Medicine, University of Toronto, Toronto, Canada.Department of Internal Medicine, University of Toronto, Toronto, Canada.General Internal Medicine and Clinical Pharmacology, University of Toronto, Toronto, Canada.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

24859547

Citation

Zipursky, Jonathan Samuel, et al. "A Rare Presentation of an Ancient Disease: Scurvy Presenting as Orthostatic Hypotension." BMJ Case Reports, vol. 2014, 2014.
Zipursky JS, Alhashemi A, Juurlink D. A rare presentation of an ancient disease: scurvy presenting as orthostatic hypotension. BMJ Case Rep. 2014;2014.
Zipursky, J. S., Alhashemi, A., & Juurlink, D. (2014). A rare presentation of an ancient disease: scurvy presenting as orthostatic hypotension. BMJ Case Reports, 2014. https://doi.org/10.1136/bcr-2013-201982
Zipursky JS, Alhashemi A, Juurlink D. A Rare Presentation of an Ancient Disease: Scurvy Presenting as Orthostatic Hypotension. BMJ Case Rep. 2014 May 23;2014 PubMed PMID: 24859547.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A rare presentation of an ancient disease: scurvy presenting as orthostatic hypotension. AU - Zipursky,Jonathan Samuel, AU - Alhashemi,Ahmad, AU - Juurlink,David, Y1 - 2014/05/23/ PY - 2014/5/27/entrez PY - 2014/5/27/pubmed PY - 2015/1/7/medline JF - BMJ case reports JO - BMJ Case Rep VL - 2014 N2 - A 49-year-old man presented to hospital with severe orthostatic hypotension, gingival dysplasia and a purpuric rash involving his extremities. The orthostatic hypotension failed to respond to fluids and, on the basis of physical examination and dietary history, the patient was given a preliminary diagnosis of scurvy (ascorbic acid deficiency). Serum ascorbic acid levels were undetectable and the orthostasis was resolved within 24 h of ascorbic acid replacement. The pathogenesis of orthostatic hypotension in the setting of scurvy appears to involve impaired catecholamine synthesis and attenuated vasomotor response to α-adrenergic stimulation. We believe that this case describes a rare presentation of scurvy and highlights a previously under-reported connection between scurvy and vasomotor instability. SN - 1757-790X UR - https://www.unboundmedicine.com/medline/citation/24859547/A_rare_presentation_of_an_ancient_disease:_scurvy_presenting_as_orthostatic_hypotension_ L2 - https://casereports.bmj.com/cgi/pmidlookup?view=long&pmid=24859547 DB - PRIME DP - Unbound Medicine ER -