Vitamin C Deficiency Masquerading as Vasculitis in a Patient With Crohn's Disease.

IF 1 Q3 MEDICINE, GENERAL & INTERNAL Cureus Pub Date : 2024-02-29 eCollection Date: 2024-02-01 DOI:10.7759/cureus.55295
Kritin K Verma, Fatma Z Deligonul, Helen Chen, Michelle Tarbox
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Abstract

This case study features a 40-year-old male with Crohn's disease (CD) who was initially misdiagnosed with vasculitis but was later shown to have scurvy owing to vitamin C deficiency. The patient's diet was nearly exclusively made up of highly processed fast food, with no fresh fruits or vegetables. A mildly sensitive, violaceous rash on his lower legs, mild gingival hemorrhage and enlargement, and muscle soreness were among his symptoms. Anemia and undetectable vitamin C levels were discovered in laboratory studies. A skin sample revealed follicular hyperkeratosis, coiled hairs, and perifollicular bleeding, eliminating the possibility of vasculitis. Scurvy was confirmed by undetectable vitamin C levels and intramuscular bleeding discovered during a muscle biopsy. After one month of vitamin C administration, the patient's skin was entirely clear. This instance emphasizes the significance of taking vitamin C insufficiency into account in patients with CD and other disorders that can cause malabsorption. Misdiagnosis might result in unneeded treatments and medical expenses. Scurvy must be diagnosed as soon as possible because it might cause gastrointestinal/intracerebral hemorrhage and death.

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一名克罗恩病患者伪装成血管炎的维生素 C 缺乏症
本病例研究的患者是一名患有克罗恩病(Crohn's disease,CD)的 40 岁男性,起初被误诊为血管炎,但后来被证实因缺乏维生素 C 而患有坏血病。患者的饮食几乎全是高度加工的快餐,没有新鲜水果或蔬菜。他的症状包括小腿出现轻度敏感的暴发性皮疹、轻度牙龈出血和肿大以及肌肉酸痛。实验室检查发现他贫血,维生素 C 含量检测不到。皮肤样本显示毛囊角化过度、毛发卷曲和毛囊周围出血,排除了血管炎的可能性。无法检测到的维生素 C 含量和肌肉活检中发现的肌肉内出血证实了坏血病。服用维生素 C 一个月后,患者的皮肤完全恢复了健康。这一病例强调了在患有 CD 和其他可导致吸收不良的疾病的患者中考虑维生素 C 不足的重要性。误诊可能会导致不必要的治疗和医疗费用。坏血病必须尽快确诊,因为它可能导致胃肠道/脑内出血和死亡。
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