Internal Medicine FlashcardPurpuric lesions in a 45-year old man
Section snippets
Case description
A forty-five year-old man, with a tobacco and alcohol history, affected with Crohn's disease, was admitted for haemoptysis and abdominal pain. The clinical examination showed extensive cutaneous purpuric lesions (Fig. 1A) and a purple-coloured palate with gingival inflammation (Fig. 1B). Biological analyses revealed an elevation of the C-reactive protein, at 15 mg/l, an icteric cholestasis with cytolysis and severe malnutrition demonstrated by a hypoalbuminemia of 21 g/l. The chest CT-scan showed
Discussion section
The cutaneous and mucosal purpuric lesions, in the context of alcohol intoxication and inflammatory bowel disease, called to mind the classical but rare diagnosis of scurvy. Our hypothesis was confirmed by low plasma ascorbic acid level: 0.3 mg/l (reference range 9.6–12.6). All the cutaneous and pulmonary lesions disappeared after vitamin C supplementation. Scurvy is a historical pathology described in situations of severe malnutrition [1]. It is often associated with inflammatory bowel
Conflict of interest
We have no conflict of interest related to this work.
References (4)
Eur J Clin Nutr
(2015 Sep)Postgrad Med J
(1979 Jan)
Cited by (2)
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