Scurvy: An Unusual Cause of Anemia

Scott A. Cohen, MD, Robert J. Paeglow, MD, Department of Family and Community Medicine, Albany Medical Center, Albany, NY.

J Am Board Fam Med. 2001;14(4) 

In This Article

Introduction

Nutritional deficiencies are a common cause of anemia. We describe a case of a schizophrenic patient with a rapidly declining hematocrit. The patient was a long-term inpatient at a psychiatric hospital. He was brought to the emergency department with acute anemia initially thought to be secondary to gastrointestinal bleeding. Other causes for his anemia were investigated when gastrointestinal bleeding was ruled out.

A dietary history showed that the patient's diet consisted entirely of bread, cheese, and water. The patient was transfused and given oral vitamin C. Within 48 hours his hematocrit increased from 15.8% to 28%. The patient was transferred back to the psychiatric hospital, where he continued to improve on oral vitamin C. At a follow-up visit after discharge, he had a hematocrit of 41% and no signs of additional bleeding.

The diagnosis of scurvy can often be overlooked because it is rarely encountered in present-day society. A nutritional history is important, especially in the elderly, institutionalized, eating-disordered, or psychiatric patient.

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