Shiver me timbers: a modern case report of scurvy

A 26-year-old female with a history of extreme anorexia nervosa restricting subtype presented to a hospital inpatient eating disorder unit in Denver, Colorado for medical stabilization of her severe protein calorie malnutrition. She was noted to have odd-shaped hairs and purple discoloration around the follicles on her legs consistent with corkscrew hairs and follicular hemorrhages. Labs subsequently showed an ascorbic acid (vitamin C) level of 21umol/L (normal 23–114), consistent with scurvy. This case illustrates the fact that in modern medicine, the diagnosis of scurvy requires an elevated index of suspicion for the disease and should be considered in the setting of other nutritional deficiencies.