{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:13:17Z","timestamp":1788513197109,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Vitamin C (\n                    <jats:sc>l<\/jats:sc>\n                    \u2010ascorbic acid) is an essential dietary micronutrient needed for iron absorption, collagen synthesis, antioxidant activity, and immune regulation. This retrospective analysis examines 23 patients seen in a classical hematology clinic in Appalachia between 2020 and 2025 who had severe vitamin C deficiency (&lt;\u20090.1\u2009mg\/dL). Most patients presented with anemia, fatigue, or other dermatologic findings, and over half lived in food\u2010desert regions. Micronutrient testing often revealed overlapping deficiencies, and 17% of patients experienced a bone marrow biopsy. Principal component analysis of laboratory data identified two main phenotypic clusters: socioeconomic status, which accounted for most of the variability in the data, followed by cell counts and laboratory values. Treatment approaches varied. Normalization of vitamin C levels and cytopenias was seen in patients who attended follow\u2010up, typically within 2\u20133\u2009months. This work suggests that vitamin C deficiency remains a contemporary and reversible contributor to cytopenias in hematology practice and highlights the importance of dietary and socioeconomic risk assessment during diagnostic evaluation.\n                  <\/jats:p>","DOI":"10.1111\/ejh.70224","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:15:07Z","timestamp":1779236107000},"page":"973-980","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vitamin C Deficiency Related Cytopenias in Hematology Practice: Revisiting Risk Factors of Access and Income"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4216-2617","authenticated-orcid":false,"given":"Danielle","family":"DeCicco","sequence":"first","affiliation":[{"name":"Department of Hematology\/Oncology West Virginia University Cancer Institute  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjana","family":"Nethagani","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology West Virginia University Cancer Institute  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huda","family":"Elzahrany","sequence":"additional","affiliation":[{"name":"Department of Pathology, Anatomy and Laboratory Medicine West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4279-4569","authenticated-orcid":false,"given":"Cara","family":"Randall","sequence":"additional","affiliation":[{"name":"Department of Pathology, Anatomy and Laboratory Medicine West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Platt","sequence":"additional","affiliation":[{"name":"Department of Pharmacy West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wyatt","family":"Kincell","sequence":"additional","affiliation":[{"name":"Department of Pharmacy West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1832-3161","authenticated-orcid":false,"given":"Samuel A.","family":"Merrill","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology West Virginia University Cancer Institute  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1179547619849036"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/molecules30030748"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild\u20102018\u2010315496"},{"key":"e_1_2_11_5_1","volume-title":"Williams Hematology","author":"Kaushansky K.","year":"2021"},{"key":"e_1_2_11_6_1","volume-title":"StatPearls","author":"Maxfield L.","year":"2025"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/tbm\/ibz095"},{"issue":"4","key":"e_1_2_11_8_1","first-page":"3901","article-title":"Community Adaptations to an Impending Food Desert in Rural Appalachia, USA","volume":"16","author":"Miller W. C.","year":"2016","journal-title":"Rural and Remote Health"},{"key":"e_1_2_11_9_1","volume-title":"Food Access Research Atlas\u2014Go to the Atlas","author":"Rhone A.","year":"2025"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1098\/rsta.2015.0202"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i03"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ins.2022.11.139"},{"key":"e_1_2_11_13_1","volume-title":"Diagnostic Pathology: Blood and Bone Marrow","author":"Foucar K.","year":"2023"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu15051074"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1155\/carm\/2118907"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V118.21.4775.4775"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.15406\/ipmrj.2018.03.00077"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu5114284"},{"key":"e_1_2_11_19_1","unstructured":"Ascorbic Acid \u201cLexi\u2010Comp \u201dhttps:\/\/online.lexi.com\/lco\/action\/home."}],"container-title":["European Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ejh.70224","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ejh.70224","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ejh.70224","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T08:22:28Z","timestamp":1788510148000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ejh.70224"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,19]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/ejh.70224"],"URL":"https:\/\/doi.org\/10.1111\/ejh.70224","archive":["Portico"],"relation":{},"ISSN":["0902-4441","1600-0609"],"issn-type":[{"value":"0902-4441","type":"print"},{"value":"1600-0609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,19]]},"assertion":[{"value":"2026-02-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}