Vitamin C Deficiency in an Anticoagulated Patient

• Published in: Journal of general internal medicine : JGIM Vol. 28; no. 6; pp. 852 - 854
• Main Authors: Yousef, George M., Goebel, Lynne J.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.06.2013; Springer; Springer Nature B.V
• Subjects: Anticoagulants - adverse effects; Ascorbic Acid - therapeutic use; Ascorbic Acid Deficiency - chemically induced; Ascorbic Acid Deficiency - diagnosis; Ascorbic Acid Deficiency - drug therapy; Biological and medical sciences; Clinical Practice: Clinical Vignettes; Coagulation; Drug Eruptions - diagnosis; Drug Eruptions - etiology; Drug therapy; Female; General aspects; Humans; Internal Medicine; Leg Dermatoses - chemically induced; Leg Dermatoses - diagnosis; Medical sciences; Medicine; Medicine & Public Health; Metabolic diseases; Middle Aged; Other nutritional diseases (malnutrition, nutritional and vitamin deficiencies...); Skin Diseases, Vascular - chemically induced; Skin Diseases, Vascular - diagnosis; Vitamin C; Warfarin - adverse effects; vitamin K; scurvy; vitamin C deficiency; warfarin; Human; Warfarin; Ascorbic acid; Coumarine derivatives; Nutrition disorder; Vitamin deficiency; Patient; Anticoagulant; Medicine; Scorbutus; Antivitamin K; Metabolic disorder; Malnutrition; Nutritional status; Vitamin K; scurvy: vitamin C deficiency
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1007/s11606-012-2282-3

ABSTRACT A 64-year-old woman presented with a hemorrhagic perifollicular rash on her legs while taking warfarin. After biopsy, vitamin C deficiency was suggested as the diagnosis, which ascorbic acid assays later confirmed. Clinical resolution of the rash followed supplementation with vitamin C. Patients on a vitamin K limited diet may also be limiting their intake of vitamin C. Physicians should be aware of this possible correlation, and consider checking vitamin C levels in patients with a perifollicular hemorrhagic rash or other signs of vitamin C deficiency while on warfarin.