SHM Converge Scientific Abstract ePoster Gallery-Scurvy's Zest for Disguise: Vitamin C Deficiency Mimicking Coagulation Disorders

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This case report describes scurvy, a vitamin C deficiency that can still occur in modern patients with poor nutrition, alcohol use, or malabsorption. Although commonly associated with bleeding, scurvy does not cause a coagulation disorder and may be misdiagnosed because its symptoms can mimic one.<br /><br />A man in his 60s presented with 6 weeks of extensive bruising, shortness of breath, and a chronic unhealed leg wound after a fall. He had heavy alcohol use and later reported bleeding gums, prolonged bleeding after a tooth extraction, and poor appetite for months. Exam showed widespread ecchymoses, hematomas, petechiae, pale skin, and tachycardia. Initial testing raised concern for DIC, von Willebrand disease, liver-related clotting problems, or other bleeding disorders. However, labs showed normal platelet count, normal PTT/INR, no schistocytes, normal haptoglobin, normal liver tests, and an elevated D-dimer. CT pulmonary angiography also found a subsegmental pulmonary embolism, adding to the diagnostic confusion.<br /><br />Ultimately, the patient’s vitamin C level was found to be severely low. He was treated with anticoagulation for the PE and oral vitamin C 500 mg twice daily. His symptoms and laboratory abnormalities resolved.<br /><br />The report emphasizes that scurvy can present with bruising, gum bleeding, petechiae, anemia, and poor wound healing due to defective collagen synthesis and fragile blood vessels. Because early symptoms may be nonspecific, the diagnosis is often missed. Clinicians should consider scurvy in patients with unexplained bleeding, especially when there is a restrictive diet, alcoholism, or poor nutritional intake. A careful dietary history can prevent unnecessary testing and lead to faster treatment and better outcomes.

Asset Subtitle

Kanika Malani

Meta Tag

Author List Jill O'Brien, Kanika Malani

Category Clinical Vignettes

Concept Scurvy

Concept Vitamin C Deficiency

Concept Oral vitamin C replacement

Concept Bruising

Concept Petechiae

Distinguished Non-Finalist

Presenter Organization Warren Alpert Medical School of Brown University

Presenting Author Kanika Malani

Track Adult

Keywords

scurvy

vitamin C deficiency

bruising

gum bleeding

poor wound healing

alcohol use

malnutrition

ecchymoses

petechiae

collagen synthesis

Scurvy

Vitamin C Deficiency

Oral vitamin C replacement

Bruising

Petechiae