A middle aged woman w/ PMHx Bipolar, HLD, and hypothyroidism who p/w syncope in s/o 2-3 months of LE ecchymoses/petechiae, admitted for syncope, anemia, and petechial rash ultimately diagnosed with scurvy.
Key Learning Points
-Vitamin C deficiency results in impaired collagen synthesis – typical pathologic manifestations occur in collagen-containing tissues/organs: skin, cartilage, dentin, osteoid, and capillary blood vessels – scurvy may present with gum bleeding, petechiae or ecchymoses
-The skin findings may initially resemble a vasculitis!
-Treatment is vitamin C supplementation – many of the constitutional symptoms improve within 24 hours – bruising and gingival bleeding resolve within a few weeks