Author(s)

Kazuharu Kamachi¹, Kazuko Doi², Momoka Ishida¹, Masaharu Miyahara¹, Shinya Kimura³

¹Department of Internal Medicine, Karatsu Red Cross Hospital, Japan.
²Department of Dermatology, Karatsu Red Cross Hospital, Japan.
³Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.

Scurvy is now an almost forgotten disease, but it hasn’t yet disappeared entirely. Here, we report the case of a patient with scurvy who presented with multiple hemorrhages about 5 years after undergoing pharyngeal surgery and radiochemotherapy for oropharyngeal cancer. This 60-year-old man was admitted to our hospital because of sudden onset of dyspnea and purpura. A physical examination and computed tomography revealed multifocal hemorrhages, namely, purpuras and petechiae on the legs and intramuscular and alveolar hemorrhages. Coagulation tests indicated a normal bleeding time and mild extension of the activated partial thromboplastin time. The coagulation factor activities were not low enough to account for such severe hemorrhages. No new hemorrhages were observed after admission. On questioning about his past eating habits, the patient reported having long had an extremely unbalanced diet, namely, a diet that was composed largely of carbohydrates with few fresh fruits and vegetables. This was due to the development of mechanical dysphagia after the operation. Since his vitamin C level was 0.5 μg/mL (normal range: 5.5 - 16.8 μg/mL), a diagnosis of scurvy was established. Thus, scurvy can still occur in modern times due to poor eating habits that arise from unusual settings. We must keep in mind that scurvy may be the cause when a patient presents with an apparently inexplicable tendency to hemorrhage.

Scurvy, Vitamin C, Oropharyngeal Cancer

Kamachi, K. , Doi, K. , Ishida, M. , Miyahara, M. and Kimura, S. (2016) Scurvy in the Postoperative Oropharyngeal Cancer Patient. International Journal of Clinical Medicine, 7, 577-584. doi: 10.4236/ijcm.2016.79063.