Adult scurvy associated with psychiatric disorders and breast feeding

BMJ Case Rep. 2018 Mar 30:2018:bcr2017223686. doi: 10.1136/bcr-2017-223686.

Abstract

Scurvy is a nutritional disease caused by ascorbic acid deficiency and is potentially fatal. It was originally described in the 18th century by James Lind and associated with long sea voyages and insufficient citrus consumption. Its prevalence has declined markedly over the years but has still been described sporadically in certain countries. A 22-year-old woman with an anxiety disorder and anorexia nervosa, recent pregnancy and ongoing breast feeding, presented with a 10-day history of spontaneous haematomas in the lower limbs, gingivorrhagia and fatigue. The examination was remarkable for signs of minor bleeding without haemodynamic compromise, gonalgia and pale skin. Work-up studies revealed the presence of anaemia. Direct anamnesis identified a diet based solely of tea and carbohydrates due to distorted body image. With the working diagnosis of scurvy, nutritional support and oral vitamin C supplementation was initiated. Her symptoms and anaemia resolved in 30 days and the diagnosis was confirmed biochemically.

Keywords: anxiety disorders (including OCD and PTSD); eating disorders; global health; nutritional support.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anemia / etiology
  • Anorexia Nervosa / complications*
  • Anxiety Disorders / complications*
  • Ascorbic Acid / therapeutic use
  • Breast Feeding*
  • Diagnosis, Differential
  • Diet / adverse effects*
  • Dietary Carbohydrates
  • Dietary Supplements
  • Fatigue / etiology
  • Female
  • Gingival Hemorrhage / etiology
  • Hematoma / etiology
  • Humans
  • Scurvy / complications*
  • Scurvy / diagnosis*
  • Scurvy / drug therapy
  • Tea
  • Young Adult

Substances

  • Dietary Carbohydrates
  • Tea
  • Ascorbic Acid