Today we had a great case of acute onset bruising associated with corkscrew hairs and hemarthroses who was found to have Scurvy.
Scurvy is due to vitamin C deficiency and should be suspected in patients with new bruising, fatigue, weakness, hemarthrosis, corkscrew hairs and perifollicular hyperkeratotic papules.
In patients with a normal PT and aPTT you should consider the following:
Von Willebrand disease
Factor XIII deficiency
People who are at risk of scurvy are vulnerable populations (food insecurity, elderly, dementia), strict diets, eating disorders, smoker, alcoholism and the mentally delayed.
Want to learn more: Reuler, J. B., Broudy, V. C., & Cooney, T. G. (1985). Adult scurvy. JAMA, 253(6), 805-807.