Skin, muscle and joint disease from the 17th century: scurvy.
We report three cases of scurvy, with differing musculoskeletal presentations, from a tertiary teaching hospital in Sydney, Australia. Case 1 was a man with cerebral palsy who presented with knee swelling following a minor injury. In Case 2, a patient with thalassaemia major presented with purpuric rash, difficulty walking and distal thigh swelling and ecchymosis. Case 3 was a man with Down's syndrome who presented with acute ankle arthritis. Scurvy in Cases 1 and 3 were related to abnormal dietary preferences, whereas in Case 2, scurvy was thought to be related to thalassaemia. All three cases responded rapidly to vitamin C replacement. The subjects did not appear malnourished as they had adequate carbohydrate and protein intake.
Lau
Herman
H
Department of Rheumatology, Liverpool Hospital, Liverpool, NSW, Australia. hermanlau@iinet.net.au
Massasso
David
D
Joshua
Fredrick
F
D000328:Adult; D001205:Ascorbic Acid / Q000008:administration & dosage; D001206:Ascorbic Acid Deficiency / Q000150:complications / Q000175:diagnosis / Q000178:diet therapy; D002547:Cerebral Palsy / Q000150:complications / Q000178:diet therapy / Q000473:pathology; D004314:Down Syndrome / Q000150:complications / Q000473:pathology; D005247:Feeding Behavior; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D012614:Scurvy / Q000150:complications / Q000175:diagnosis* / Q000178:diet therapy; D016896:Treatment Outcome; D017086:beta-Thalassemia / Q000150:complications / Q000178:diet therapy / Q000473:pathology
D001205:Ascorbic Acid