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especially vasculitides&#44; as cutaneous purpura is one of its most characteristic clinical manifestations&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We report the case of a 42-year-old man with a history of paranoid schizophrenia&#44; who came to the emergency department with pain and progressive swelling of his left knee that had begun 2 weeks earlier&#46; He had experienced no previous injury&#46; Physical examination revealed gingivitis&#44; purpuric cutaneous lesions and arthritis in his left knee&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">He underwent arthrocentesis had yielded a blood-stained fluid &#40;940&#44;000<span class="elsevierStyleHsp" style=""></span>&#956;L red blood cells&#44; 24&#44;550<span class="elsevierStyleHsp" style=""></span>&#956;L nucleated cells&#8212;11&#37; lymphocytes and 89&#37; neutrophils&#8212;and 56<span class="elsevierStyleHsp" style=""></span>g&#47;L proteins&#41;&#46; A plain radiograph of the knee was normal and magnetic resonance imaging &#40;MRI&#41; revealed marked joint effusion and substantial intra-articular circumferential edematous infiltration&#44; which was reported to be compatible with hemarthrosis&#44; with no other pathologic findings &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; On the other hand&#44; a biopsy of the purpuric skin lesions showed extravasation of blood and siderophages&#44; with no inflammatory infiltrate&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Antinuclear antibodies &#40;ANA&#41;&#44; antineutrophil cytoplasmic antibodies &#40;ANCA&#41;&#44; cultures of joint fluid&#44; serological tests for hepatitis B or C virus and human immunodeficiency virus&#44; as well as coagulation tests&#44; routine analyses&#44; and determination of acute-phase reactants were negative or normal&#46; The medical history referred to a restrictive diet&#44; in which the patient ate only milk and yogurt&#44; as well as previous episodes of gingival bleeding&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The serum vitamin C levels were &#60;0&#46;10<span class="elsevierStyleHsp" style=""></span>mg&#47;dL &#40;normal values&#58; 0&#46;4&#8211;2<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">After the diagnosis of scurvy&#44; treatment was begun with vitamin C supplements and a supervised diet&#46; The outcome was positive&#44; with a rapid improvement of the skin lesions and resolution of the hemarthrosis&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">At present&#44; scurvy is a rare finding in developed countries&#44;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a> but rheumatologists should consider this possibility in the case of spontaneous hemarthrosis&#44; especially if it is accompanied by other hemorrhagic manifestations or eating disorders&#44; taking into account that the definitive diagnosis is usually confirmed <span class="elsevierStyleItalic">a posteriori</span>&#44; as vitamin C levels are not routinely determined&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">In short&#44; scurvy is a very rare deficiency disease in western countries&#44; although it can be observed in some psychiatric patients and alcoholics with eating disorders&#46; With this case&#44; we would like to remind professionals of this condition as the cause of rheumatic disease and&#44; although not very frequent&#44; it must be taken into account in the differential diagnosis of hemarthrosis&#46; The key to the diagnosis is still in the physical examination and the medical history&#44; although the usual ancillary tests are exclusively a help to rule out other processes&#46;</p></span>"
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Letter to the Editor
Hemarthrosis and Scurvy
Hemartrosis por escorbuto
Anahy M. Brandy-Garcíaa,
Corresponding author
anahymbg@gmail.com

Corresponding author.
, Iván Cabezas-Rodrígueza, Daniel Caravia-Duránb, Luis Caminal-Monterob
a Servicio de Reumatología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
b Unidad de Enfermedades Autoinmunes Sistémicas, Unidad de Gestión Clínica de Medicina Interna, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Hemarthrosis refers to the presence of intraarticular blood and its usual presentation is acute monoarthritis&#44; generally of the knee&#46; The differential diagnosis of spontaneous hemarthrosis includes coagulation disorders&#44; pigmented villonodular synovitis&#44; vasculitis&#44; rheumatoid arthritis and calcium pyrophosphate or hydroxyapatite crystal deposition diseases&#44; among other causes&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">On the other hand&#44; scurvy is a disease provoked by deficiency of vitamin C or ascorbic acid&#44; a water-soluble vitamin involved in collagen synthesis through the hydroxylation of lysine and proline in precollagen&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> The diagnosis of scurvy is clinical and it is necessary to consider an extensive differential diagnosis with a number of diseases&#44; especially vasculitides&#44; as cutaneous purpura is one of its most characteristic clinical manifestations&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We report the case of a 42-year-old man with a history of paranoid schizophrenia&#44; who came to the emergency department with pain and progressive swelling of his left knee that had begun 2 weeks earlier&#46; He had experienced no previous injury&#46; Physical examination revealed gingivitis&#44; purpuric cutaneous lesions and arthritis in his left knee&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">He underwent arthrocentesis had yielded a blood-stained fluid &#40;940&#44;000<span class="elsevierStyleHsp" style=""></span>&#956;L red blood cells&#44; 24&#44;550<span class="elsevierStyleHsp" style=""></span>&#956;L nucleated cells&#8212;11&#37; lymphocytes and 89&#37; neutrophils&#8212;and 56<span class="elsevierStyleHsp" style=""></span>g&#47;L proteins&#41;&#46; A plain radiograph of the knee was normal and magnetic resonance imaging &#40;MRI&#41; revealed marked joint effusion and substantial intra-articular circumferential edematous infiltration&#44; which was reported to be compatible with hemarthrosis&#44; with no other pathologic findings &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; On the other hand&#44; a biopsy of the purpuric skin lesions showed extravasation of blood and siderophages&#44; with no inflammatory infiltrate&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Antinuclear antibodies &#40;ANA&#41;&#44; antineutrophil cytoplasmic antibodies &#40;ANCA&#41;&#44; cultures of joint fluid&#44; serological tests for hepatitis B or C virus and human immunodeficiency virus&#44; as well as coagulation tests&#44; routine analyses&#44; and determination of acute-phase reactants were negative or normal&#46; The medical history referred to a restrictive diet&#44; in which the patient ate only milk and yogurt&#44; as well as previous episodes of gingival bleeding&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The serum vitamin C levels were &#60;0&#46;10<span class="elsevierStyleHsp" style=""></span>mg&#47;dL &#40;normal values&#58; 0&#46;4&#8211;2<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">After the diagnosis of scurvy&#44; treatment was begun with vitamin C supplements and a supervised diet&#46; The outcome was positive&#44; with a rapid improvement of the skin lesions and resolution of the hemarthrosis&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">At present&#44; scurvy is a rare finding in developed countries&#44;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a> but rheumatologists should consider this possibility in the case of spontaneous hemarthrosis&#44; especially if it is accompanied by other hemorrhagic manifestations or eating disorders&#44; taking into account that the definitive diagnosis is usually confirmed <span class="elsevierStyleItalic">a posteriori</span>&#44; as vitamin C levels are not routinely determined&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">In short&#44; scurvy is a very rare deficiency disease in western countries&#44; although it can be observed in some psychiatric patients and alcoholics with eating disorders&#46; With this case&#44; we would like to remind professionals of this condition as the cause of rheumatic disease and&#44; although not very frequent&#44; it must be taken into account in the differential diagnosis of hemarthrosis&#46; The key to the diagnosis is still in the physical examination and the medical history&#44; although the usual ancillary tests are exclusively a help to rule out other processes&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Brandy-Garc&#237;a AM&#44; Cabezas-Rodr&#237;guez I&#44; Caravia-Dur&#225;n D&#44; Caminal-Montero L&#46; Hemartrosis por escorbuto&#46; Reumatol Clin&#46; 2017&#59;13&#58;364&#8211;365&#46;</p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Coronal T2-weighted magnetic resonance image of the left knee of the patient&#46; A hyperintense signal can be observed in the anterior region in different phases compatible with hemarthrosis&#46;</p>"
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute monoarthritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;G&#46; Baker"
                            1 => "H&#46;R&#46; Schumacher Jr&#46;"
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                    ]
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                    0 => array:2 [
                      "doi" => "10.1056/NEJM199309303291407"
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                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1993"
                        "volumen" => "329"
                        "paginaInicial" => "1013"
                        "paginaFinal" => "1020"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8366902"
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                  ]
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              "identificador" => "bib0030"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rheumatic manifestations of scurvy&#58; a report of three recent cases in a major urban center and a review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;T Mertens"
                            1 => "E&#46; Gertner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.semarthrit.2010.10.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Semin Arthritis Rheum"
                        "fecha" => "2011"
                        "volumen" => "41"
                        "paginaInicial" => "286"
                        "paginaFinal" => "290"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21185063"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hemarthrosis as initial presentation of scurvy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;L&#46; Pangan"
                            1 => "D&#46; Robinson"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Rheumatol"
                        "fecha" => "2001"
                        "volumen" => "28"
                        "paginaInicial" => "1923"
                        "paginaFinal" => "1925"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11508601"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Scurvy&#58; Past&#44; present&#44; and future"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46; Magiorkinis"
                            1 => "A&#46; Beloukas"
                            2 => "A&#46; Diamantis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejim.2010.10.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Intern Med"
                        "fecha" => "2011"
                        "volumen" => "22"
                        "paginaInicial" => "147"
                        "paginaFinal" => "152"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21402244"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
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Idiomas
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