Vitamin C Deficiency With Oral Lesions As Initial Symptom

This case report describes a 24-year-old man with a complaint of gingival hyperplasia in oral medicine department. He was eventually diagnosed with vitamin C deficiency according to his presentation, eating habit and the successful experimental therapy. A 24-year-old man presented with a 2-month history of gingival hyperplasia and a 1-week history of purpura on lower extremities. The gingiva had areas that appeared purple and eroded. The left upper gingiva bled spontaneously. He rarely ate vegetables or fruits and his diet consisted mainly of instant noodles. Laboratory data revealed hypokalaemia and anaemia. Radiography revealed alveolar bone resorption. Gingival biopsy revealed dilated subepithelial blood vessels and erythrocytic extravasation. There were no abnormal changes of bone marrow puncture. The patient was treated for vitamin C deficiency. The purpura improved after a 1-week diet with more fruits and vegetables. Gingival changes resolved after five months of treatment with a balanced diet and vitamin C. Therefore, successful experimental therapy established the diagnosis of scurvy. Vitamin C level in this case was not detected because of the conditions. The patient was diagnosed according to his clinical features, laboratory findings and successful experimental therapy. Vitamin C deficiency is one of the oldest diseases in human history, while it continues to occur in vulnerable populations. The purpose of this report is to help stomatologists to recall and identify vitamin C deficiency.