University of Wisconsin–Madison Medical College of Wisconsin

Scurvy Presenting as Blood Loss Anemia in the United States

Samantha Rivera, MD; Adam Clements, DO; Joshua Hess, MD; Nicolai Gerhartz, PA-C; Aleksander Downs, MD; Linnea Kruit, MD

WMJ. 2023;122(1):63-66.

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Introduction: Scurvy is a deadly disease caused by a lack of vitamin C in the diet. Although frequently considered a disease from the past, it still occurs in modern-day society, including in developed countries.

Case Presentation: We report a case of an 18-year-old male who was admitted with bleeding into his legs, prolonged prothrombin time and partial thromboplastin time, and anemia requiring a blood transfusion. His history included congenital deafness and a restrictive eating pattern primarily consisting of fast food. He was deficient in folic acid, vitamin K, and vitamin C. Scurvy best explained the bleeding, and he improved with vitamin supplementation.

Discussion: Scurvy is a collagen production disorder that can cause bleeding on the skin and mucous membranes. Although rare in industrialized nations, scurvy is typically the result of a restrictive diet or malnutrition. Those who are at a particularly high risk are the elderly, alcohol abusers, and those with eating disorders.

Conclusions: Scurvy is easily treatable but can be missed; therefore, a high level of suspicion should be present in patients at risk for malnutrition. Those diagnosed with scurvy should be screened for concomitant nutritional deficiencies.

Author Affiliations: Aspirus Wausau Family Medicine, Wausau, Wisconsin (Rivera, Hess); Aspirus Wausau Hospital, Wausau, Wis (Clements, Gerhartz); ProHealth Waukesha Memorial Hospital, Waukesha, Wis (Downs); Western Wisconsin Family Medicine, New Richmond, Wis (Kruit).
Corresponding Author: Samantha Rivera, MD, PGY-3 Family Medicine Resident, Aspirus Wausau Family Medicine, 333 Pine Ridge Blvd, Wausau, WI 54401; phone 720.272.6531; email
Financial Disclosures: None declared.
Funding/Support: None declared.
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