Doctors who treated a man with scurvy who couldn’t afford to eat fresh fruit and vegetables say the cost of living crisis could trigger more cases of the condition.
The popularity of weight loss surgery could also fuel a rise in scurvy cases, a condition which is caused by a lack of vitamin C.
It comes after doctors treated a middle-aged man who presented with painful, small red-brown dots on his legs, which looked like a rash. He was also anaemic and had blood in his urine.
Initial tests showed he was not suffering from any inflammatory, autoimmune or blood disorders, or internal bleeding.
A skin biopsy also failed to shed any light on what the issue was.
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With his rash continuing to spread, doctors discovered that he was short of money and was often missing meals. He was eating very little fruit and vegetables. In addition, he had stopped taking the nutritional supplements he was given after weight-loss surgery, due to a lack of funds.
Subsequent blood tests found no detectable levels of vitamin C and very low levels of other important nutrients. This led to a diagnosis of scurvy and once the patient started taking daily vitamin C, vitamin D3, folic acid and multivitamins, his rash and other symptoms cleared up.
The study authors say that scurvy is “still seen as a disease of the past, especially in developed countries” and pointed out that complications following weight-loss surgery have resulted in more cases of scurvy being reported.
Other risk factors for scurvy include alcoholism, smoking, eating disorders, low household income, obesity, kidney dialysis and drugs that affect vitamin C absorption, including steroids and those that restrict stomach acid production (proton pump inhibitors).
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The authors commented: “Our patient had multiple risk factors, namely, poor dietary habits, obesity, previous bariatric surgery, use of proton pump inhibitors and low-income status. His history of iron, vitamin D and folate deficiencies were also clues to his underlying nutritional deficiency.”
They went on to say: “This disease is easily reversible with supplementation, with a dramatic response seen within 24 hours. Failure to treat may lead to catastrophic haemorrhage, hence, early recognition and prompt treatment are vital.”
Read more in BMJ Case Reports.
