Research and practice in thrombosis and haemostasis · 2026
Unexplained bleeding tendency and scleroderma-like skin changes: a diagnostic journey to vitamin C deficiency.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Winkler Florian, Heil Peter Maximilian, Thaler Johannes, Sperr Wolfgang R, Ay Cihan, Strobl Johanna, Gebhart Johanna, Mehic Dino
Аннотация
BACKGROUND: A subset of patients with a bleeding tendency undergoing hemostatic evaluation may be misdiagnosed as bleeding disorder of unknown cause (BDUC).
KEY CLINICAL QUESTION: Should vitamin C deficiency be considered in patients with bleeding symptoms but normal hemostatic test results suggestive of BDUC?
CLINICAL APPROACH: We report on a patient with bleeding symptoms despite normal hemostatic examination, in whom vitamin C deficiency was ultimately identified as the cause of the bleeding disorder. The patient, a 26-year-old man, presented with extensive ecchymoses, anemia, and sclerodermatous skin changes of the left leg. His nutritional anamnesis revealed markedly restricted eating habits. Vitamin C supplementation led to normalization of hemoglobin levels and marked improvement of the sclerodermatous skin changes.
CONCLUSION: This case demonstrates that vitamin C deficiency can mimic hematologic and dermatologic disorders and highlights the importance of considering nutritional deficiencies as potential causes of bleeding, even in high-income countries.
KEY CLINICAL QUESTION: Should vitamin C deficiency be considered in patients with bleeding symptoms but normal hemostatic test results suggestive of BDUC?
CLINICAL APPROACH: We report on a patient with bleeding symptoms despite normal hemostatic examination, in whom vitamin C deficiency was ultimately identified as the cause of the bleeding disorder. The patient, a 26-year-old man, presented with extensive ecchymoses, anemia, and sclerodermatous skin changes of the left leg. His nutritional anamnesis revealed markedly restricted eating habits. Vitamin C supplementation led to normalization of hemoglobin levels and marked improvement of the sclerodermatous skin changes.
CONCLUSION: This case demonstrates that vitamin C deficiency can mimic hematologic and dermatologic disorders and highlights the importance of considering nutritional deficiencies as potential causes of bleeding, even in high-income countries.