Doctors in the journal BMJ Case Reports believe that the scourge of scurvy, which is caused by vitamin C deficiency, may be rearing its ugly head again because of the cost of living crisis and the increase in weight loss (bariatric) surgery.
Despite being a thoroughly curable disease, the possibility of confusing it with vasculitis, known as a disease of the past that affected sailors during the renaissance period, risky fatal bleeding in case of continued advancements are pointed out by the authors.
The authors described a 48-year-old male patient who had numerous small tiny painful red-brown wheals over the legs. He also had hematuria and was anaemic.
He turned out negative for inflammatory, autoimmune, or blood disorders, and the scans also did not show internal bleeding. Likewise, a skin Biopsy yielded no results to help diagnose the problem.
His rash continued to spread while he was in hospital which is an advice he had taken from one of the hospitals. And further probing, he admitted he had little money and poorly overrated while consuming minimal fruits and vegetables.
He stated that at times he realised he had missed breakfast, or even lunch in the entire day. He had also abandoned the nutritional supplements as advised to him after his previous weight loss surgeries since he alleged that he could not afford them.
A series of blood tests to determine his overall nutritional reserves showed that there were no measurable vitamin C levels, and that other nutrients were present in very low concentrations.
He was diagnosed with scurvy and given daily oral supplements of vitamin C (1,000 mg), vitamin D3, folic acid and multivitamin as well as his painful rash and other symptoms disappeared.
The dwindling economy also complicates the challenges of feeding a family with good quality nutritious foods since they are expensive while turning to the internet, there are numerous reports of individuals getting scurvy as a result of the complications arising from bariatric surgery.
Citing other predisposing factors to scurvy as alcoholism, smoking, eating disorders, low household income, obesity, renal dialysis, and some vitamin C interacting drugs like steroids, and proton pump inhibitors, they note.
Several modifiable risk factors were identified in our patient, namely poor diet, obesity, prior bariatric surgery, PPI exposure, and low income status. Other evidence pointing to his nutritional deficiency was also established; he had a history of low iron, vitamin D and folic acid level intake.
Reference: British Medical Journal. Scurvy may be re-emerging amid cost of living crisis and rise of weight loss surgery.
