eISSN: 1689-3530
ISSN: 0867-4361
Alcoholism and Drug Addiction/Alkoholizm i Narkomania
Current issue Archive Online first About the journal Editorial board Abstracting and indexing Subscription Contact Instructions for authors Publication charge Ethical standards and procedures
Editorial System
Submit your Manuscript
4/2020
vol. 33
 
Share:
Share:
abstract:
Case report

Nutritional deficiencies of the opioid epidemic: a story of scurvy masquerading as systemic lupus erythematosus

Nasha Elavia
1
,
Alok Joshi
1
,
Si Li
1
,
Jumee Barooah
2

  1. The Wright Center for Graduate Medical Education, Scranton PA, USA
  2. The Wright Center for Community Health, Jermyn PA, USA
Alcohol Drug Addict 2020; 33 (4): 369-372
Online publish date: 2021/04/19
View full text Get citation
 
PlumX metrics:
Introduction
Scurvy is uncommon in developed countries. Nevertheless, rare cases still do occur. Early recognition of scurvy can be difficult because symptoms may appear nonspecific and can mimic more common conditions. In any patient with spontaneous hematoma and purpura, in the context of a nutritional disorder, scurvy should be considered.

Case description
We describe a 49-year-old female with a history of systemic lupus erythematosus (SLE), irritable bowel syndrome (IBS) and opioid dependence with a three-week history of painless ecchymosis on the left hip and bleeding in her gums. Examination of the oral cavity showed mildly pale gums with oozing of blood on applying gentle pressure. There was also mild tenderness of the gums. Laboratory investigations were remarkable for vitamin C deficiency in the absence of anaemia. A coagulation panel was unremarkable. The patient was treated with oral vitamin C replacement, resulting in the resolution of her symptoms.

Commentary
Scurvy has been found to mimic symptoms of connective tissue disease. Patients’ social and family history needs to be explored in detail prior to the diagnosis of autoimmune disorders as these have different treatment approach and implications. The burden of nutritional deficiencies in dependence and the potential scope of nutrition services in drug detoxification programmes needs to be further investigated. Future directions include a more widespread study to determine the scope of various nutritional deficiencies in patients with opioid dependence.

keywords:

Dependence, Vitamin C, Opioids, Scurvy, Nutritional deficiency

Quick links
© 2024 Termedia Sp. z o.o.
Developed by Bentus.