SHM Converge Scientific Abstract ePoster Gallery-A Mystery of Bruising and Pain: Solved by Vitamin C

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Here is a polished <strong>UT Southwestern conference poster draft</strong> based on your abstract. I formatted it in a clear, professional style suitable for a clinical poster. You can paste this into PowerPoint/Illustrator and add your clinical photo as Figure 1.

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<h1>**A Mystery of Bruising and Pain: Solved by Vitamin C**</h1>
<strong>Angela L. Young, BS; Sukul Mittal, BS; Fredy Calderon, MD; Keith Liu, MD</strong>  
<strong>University of Texas Southwestern Medical Center</strong>

<h2>**Background**</h2>
Vitamin C (ascorbic acid) is essential for collagen synthesis, iron absorption, and connective tissue integrity. Deficiency causes capillary fragility and impaired wound healing, resulting in scurvy. Although uncommon in developed countries, scurvy persists in patients with poor nutrition, chronic disability, immobility, or limited access to nutritious foods.

<h2>**Objective**</h2>
To highlight vitamin C deficiency as an underrecognized cause of bruising, mucocutaneous bleeding, and diffuse musculoskeletal pain in medically complex adults, and to emphasize the importance of dietary history and nutritional assessment.

<h2>**Case Presentation**</h2>
A 48-year-old man with a history of congenital C5 spinal cord injury, spastic quadriparesis, contractures, and chronic musculoskeletal pain presented with 2 weeks of progressive diffuse pain, easy bruising, petechiae, gingival bleeding, nausea, poor oral intake, and functional decline.

<strong>Physical Exam</strong>
- BMI: 17.9 kg/m²  
- Numerous petechiae and ecchymoses on extremities  
- Inflamed gingiva with soft tissue overgrowth  
- Chronically ill appearing  
- Neurologic exam consistent with baseline spastic quadriparesis

<h2>**Key Laboratory Findings**</h2>
- Hgb 10.9 g/dL  
- Iron 39 µg/dL  
- Transferrin saturation 14%  
- Ferritin 47 ng/mL  
- CRP 12.9 mg/L  
- Platelets normal  
- Coagulation studies normal  
- <strong>Serum vitamin C 0.1 mg/dL</strong>

<h2>**Discussion**</h2>
This case illustrates a rare but clinically important diagnosis of vitamin C deficiency in a medically complex, immobile patient in a developed country. Vitamin C is a cofactor for proline and lysine hydroxylation in collagen synthesis; deficiency weakens connective tissue, producing fragile capillaries, poor wound healing, and musculoskeletal pain. Symptoms such as petechiae, ecchymoses, gingival bleeding, fatigue, and elevated inflammatory markers may mimic hematologic or rheumatologic disease, leading to delayed diagnosis. Early recognition is important because supplementation can rapidly reverse symptoms and prevent unnecessary workup.

<h2>**Treatment and Outcome**</h2>
- Vitamin C 500 mg orally twice daily  
- Nutrition consultation  
- Dietary counseling  

The patient had significant improvement in pain, appetite, and functional status at follow-up.

<h2>**Conclusion**</h2>
Vitamin C deficiency should remain in the differential diagnosis for unexplained bruising, bleeding, or diffuse pain, especially in patients with chronic disability, malnutrition, or social barriers to nutrition.

<h2>**Figure 1**</h2>
<strong>Clinical photograph showing numerous petechiae and scattered ecchymoses on the lower extremities consistent with capillary fragility from vitamin C deficiency (scurvy).</strong>

<h2>**Selected References**</h2>
1. Lachance PA, Langseth L. Nutr Clin Pract. 2019;34(4):602-610.  
2. Padayatty SJ, Levine M. Nutrients. 2016;8(12):868.  
3. Lane DJR, Richardson DR. Biochem Biophys Res Commun. 2014;445(4):509-514.  
4. Olmedo JM, et al. Int J Dermatol. 2006;45(8):909-913.  
5. White JV, et al. J Acad Nutr Diet. 2012;112(5):730-738.  
6. Smith A, Thorpe L. Hosp Pract. 2021;49(3):171-180.

If you want, I can also turn this into:
1. a <strong>1-slide poster layout with section boxes</strong>,  
2. a <strong>more visually polished UTSW-style poster text</strong>, or  
3. a <strong>short 300-word conference abstract version</strong>.

Asset Subtitle

Angela L. Young

Meta Tag

Author List Angela L. Young, Fredy Calderon, Keith Liu, Sukul MIttal

Category Clinical Vignettes

Concept Vitamin C Deficiency

Concept Bruising

Concept Mucocutaneous Bleeding

Concept Dietary History

Concept Musculoskeletal pain

Distinguished Non-Finalist

Presenter Organization UT Southwestern

Presenting Author Angela L. Young

Track Adult

Keywords

vitamin C deficiency

scurvy

bruising

petechiae

gingival bleeding

musculoskeletal pain

collagen synthesis

malnutrition

spinal cord injury

clinical case report

Vitamin C Deficiency

Bruising

Mucocutaneous Bleeding

Dietary History

Musculoskeletal pain