Haemorrhagic Pericardial Effusion as the Presenting Symptom of Scurvy
INTRODUCTION: Vitamin C deficiency (or scurvy) usually takes weeks to become apparent as cutaneous signs and impaired wound healing. Haemorrhagic pericarditis remains a rare complication of scurvy, which has never been reported as an isolated condition. We report the case of a haemorrhagic pericardi...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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SMC Media Srl
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10482132/ https://www.ncbi.nlm.nih.gov/pubmed/37680776 http://dx.doi.org/10.12890/2023_004026 |
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author | Joulal, Hajar Yousfi, Jaouad Benjilali, Laïla Zahlane, Mouna Essaadouni, Lamiaa |
author_facet | Joulal, Hajar Yousfi, Jaouad Benjilali, Laïla Zahlane, Mouna Essaadouni, Lamiaa |
author_sort | Joulal, Hajar |
collection | PubMed |
description | INTRODUCTION: Vitamin C deficiency (or scurvy) usually takes weeks to become apparent as cutaneous signs and impaired wound healing. Haemorrhagic pericarditis remains a rare complication of scurvy, which has never been reported as an isolated condition. We report the case of a haemorrhagic pericarditis revealing a vitamin C deficiency in a 56-year-old patient. CASE DESCRIPTION: A 56-year-old woman presented with a 2-week history of worsening chest pain and dyspnoea, with no significant medical history. Upon admission, the patient exhibited tachycardia, tachypnoea, low blood pressure, elevated jugular venous pressure, muffled heart sounds and multiple petechiae on her lower limbs. An ultrasound revealed a large pericardial effusion, and an emergency pericardiocentesis was performed, which yielded haemorrhagic fluid without atypical cells. An initial workup including haemoculture, PT and PTT, tuberculosis workup, autoantibodies, tumour markers and infectious disease was negative. A whole-body CT scan showed no evidence of tuberculosis or lymphoma. Additional testing showed that her vitamin C level was <3 umol/L. Following stabilisation, high-dose vitamin C therapy was initiated. Subsequently, she showed continued clinical improvement and remained asymptomatic upon her discharge. DISCUSSION: While uncommon, it is crucial to investigate vitamin C deficiency when confronted with an unexplained haemorrhagic pericardial effusion, particularly in patients with risk factors. CONCLUSION: Our case highlights the significance of early detection of this condition in promptly addressing the diverse complications of scurvy, thereby enhancing the prognosis of a potentially fatal condition. LEARNING POINTS: Haemorrhagic pericarditis could be an initial indication of scurvy. Vitamin C deficiency must be included in the differential diagnostic of haemorrhagic tamponade, even in the absence of a typical signs and symptoms of scurvy. |
format | Online Article Text |
id | pubmed-10482132 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SMC Media Srl |
record_format | MEDLINE/PubMed |
spelling | pubmed-104821322023-09-07 Haemorrhagic Pericardial Effusion as the Presenting Symptom of Scurvy Joulal, Hajar Yousfi, Jaouad Benjilali, Laïla Zahlane, Mouna Essaadouni, Lamiaa Eur J Case Rep Intern Med Article INTRODUCTION: Vitamin C deficiency (or scurvy) usually takes weeks to become apparent as cutaneous signs and impaired wound healing. Haemorrhagic pericarditis remains a rare complication of scurvy, which has never been reported as an isolated condition. We report the case of a haemorrhagic pericarditis revealing a vitamin C deficiency in a 56-year-old patient. CASE DESCRIPTION: A 56-year-old woman presented with a 2-week history of worsening chest pain and dyspnoea, with no significant medical history. Upon admission, the patient exhibited tachycardia, tachypnoea, low blood pressure, elevated jugular venous pressure, muffled heart sounds and multiple petechiae on her lower limbs. An ultrasound revealed a large pericardial effusion, and an emergency pericardiocentesis was performed, which yielded haemorrhagic fluid without atypical cells. An initial workup including haemoculture, PT and PTT, tuberculosis workup, autoantibodies, tumour markers and infectious disease was negative. A whole-body CT scan showed no evidence of tuberculosis or lymphoma. Additional testing showed that her vitamin C level was <3 umol/L. Following stabilisation, high-dose vitamin C therapy was initiated. Subsequently, she showed continued clinical improvement and remained asymptomatic upon her discharge. DISCUSSION: While uncommon, it is crucial to investigate vitamin C deficiency when confronted with an unexplained haemorrhagic pericardial effusion, particularly in patients with risk factors. CONCLUSION: Our case highlights the significance of early detection of this condition in promptly addressing the diverse complications of scurvy, thereby enhancing the prognosis of a potentially fatal condition. LEARNING POINTS: Haemorrhagic pericarditis could be an initial indication of scurvy. Vitamin C deficiency must be included in the differential diagnostic of haemorrhagic tamponade, even in the absence of a typical signs and symptoms of scurvy. SMC Media Srl 2023-08-22 /pmc/articles/PMC10482132/ /pubmed/37680776 http://dx.doi.org/10.12890/2023_004026 Text en © EFIM 2023 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is licensed under a Commons Attribution Non-Commercial 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) |
spellingShingle | Article Joulal, Hajar Yousfi, Jaouad Benjilali, Laïla Zahlane, Mouna Essaadouni, Lamiaa Haemorrhagic Pericardial Effusion as the Presenting Symptom of Scurvy |
title | Haemorrhagic Pericardial Effusion as the Presenting Symptom of Scurvy |
title_full | Haemorrhagic Pericardial Effusion as the Presenting Symptom of Scurvy |
title_fullStr | Haemorrhagic Pericardial Effusion as the Presenting Symptom of Scurvy |
title_full_unstemmed | Haemorrhagic Pericardial Effusion as the Presenting Symptom of Scurvy |
title_short | Haemorrhagic Pericardial Effusion as the Presenting Symptom of Scurvy |
title_sort | haemorrhagic pericardial effusion as the presenting symptom of scurvy |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10482132/ https://www.ncbi.nlm.nih.gov/pubmed/37680776 http://dx.doi.org/10.12890/2023_004026 |
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