- CDC
- Heart Failure
- Cardiovascular Clinical Consult
- Adult Immunization
- Hepatic Disease
- Rare Disorders
- Pediatric Immunization
- Implementing The Topcon Ocular Telehealth Platform
- Weight Management
- Monkeypox
- Guidelines
- Men's Health
- Psychiatry
- Allergy
- Nutrition
- Women's Health
- Cardiology
- Substance Use
- Pediatrics
- Kidney Disease
- Genetics
- Complimentary & Alternative Medicine
- Dermatology
- Endocrinology
- Oral Medicine
- Otorhinolaryngologic Diseases
- Pain
- Gastrointestinal Disorders
- Geriatrics
- Infection
- Musculoskeletal Disorders
- Obesity
- Rheumatology
- Technology
- Cancer
- Nephrology
- Anemia
- Neurology
- Pulmonology
Scurvy: Easy Bruising and Bleeding Gums
Bruising is a sign/symptom to be taken seriously. This patient abused alcohol; his vitamin C deficiency confirmed the diagnosis of scurvy. This patient is also at risk for pellagra and beri beri.
A 37-year-old man presents for evaluation of “easy bruising” and “bleeding gums.” At the time of medical consultation, the smell of ethanol was detected on his breath.
Key point: As noted, bruising is a sign/symptom to be taken seriously. In this case, the combination of swollen and friable gums, along with bruising and the distinct odor of ethanol in the middle of the morning, suggested that the patient abused alcohol. As such, he might well be subject to nutritional deficiencies. His vitamin C level was 0.004 mg/dL (about one hundredth of the expected level), confirming the suspected diagnosis of scurvy. Bruising is one sign of this disorder.
Treatment: While alcohol dependence was being addressed, the patient received oral vitamin C supplementation and a diet high in fresh fruit.
Note: It is rare to find signs and symptoms of an isolated deficiency, and this patient was also at high risk for pellagra and beri beri.
Biden Administration Announces First 10 Prescription Drugs Slated for Price Negotiations
August 29th 2023The first 10 drugs identified for negotiations under the Inflation Reduction Act include several well advertised agents indicated to treat diabetes, heart failure, and other chronic diseases.
