{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:40:17Z","timestamp":1756305617459,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,5,15]]},"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:p>A man in his 50s with dialysis-dependent end-stage renal disease, several weeks history of progressive skin bruising and acute-onset gastrointestinal bleeding presented to the emergency department following a syncopal event during routine haemodialysis owing to profound hypotension. He was found to have a severe normocytic, normochromic anaemia requiring several blood transfusions. He followed a diet lacking fruits and vegetables and stopped taking renal multivitamins. All parameters of coagulation were unremarkable, but serum vitamin C level was undetectable, supporting a diagnosis of scurvy. Although typically associated with individuals who are at risk of malnourishment, such as those with alcohol use disorder, malabsorption, and those who experience homelessness, scurvy should be considered in patients receiving renal replacement therapy as vitamin C is removed during haemodialysis.<\/jats:p>","DOI":"10.1136\/bcr-2022-249711","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T13:57:53Z","timestamp":1653314273000},"page":"e249711","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Spontaneous haematomas and haematochezia due to vitamin C deficiency in a haemodialysis patient"],"prefix":"10.1136","volume":"15","author":[{"given":"James Q","family":"Zhou","sequence":"first","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Hospital Medicine Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1406-9469","authenticated-orcid":false,"given":"Marko","family":"Velimirovic","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Hospital Medicine Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leslie L","family":"Chang","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Hospital Medicine Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew Z","family":"Fenves","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Clinician Educator, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,5,23]]},"reference":[{"key":"2025082707104328000_15.5.e249711.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(99)70244-6"},{"key":"2025082707104328000_15.5.e249711.2","doi-asserted-by":"crossref","DOI":"10.1177\/1178638818809097","article-title":"Scurvy is back","volume":"11","author":"Callus","year":"2018","journal-title":"Nutr Metab Insights"},{"key":"2025082707104328000_15.5.e249711.3","doi-asserted-by":"publisher","DOI":"10.1089\/ars.2013.5205"},{"key":"2025082707104328000_15.5.e249711.4","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1080\/21533369.2013.783167","article-title":"Scurvy on sea and land: political economy and natural history, c. 1780-c. 1850","volume":"15","author":"Harrison","year":"2013","journal-title":"J Marit Res"},{"key":"2025082707104328000_15.5.e249711.5","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2008.27016"},{"key":"2025082707104328000_15.5.e249711.6","doi-asserted-by":"publisher","DOI":"10.1177\/0115426507022004445"},{"key":"2025082707104328000_15.5.e249711.7","doi-asserted-by":"crossref","DOI":"10.1182\/blood.2019002677","article-title":"Hematopoietic findings in a patient with scurvy","volume":"134","author":"Yang","year":"2019","journal-title":"Blood"},{"key":"2025082707104328000_15.5.e249711.8","doi-asserted-by":"crossref","first-page":"S83","DOI":"10.1111\/hdi.12705","article-title":"Scurvy in a hemodialysis patient. rare or ignored?: scurvy in hemodialysis patient","volume":"22","author":"Panchal","year":"2018","journal-title":"Hemodial Int"},{"key":"2025082707104328000_15.5.e249711.9","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1111\/odi.12446","article-title":"Vitamin C: the known and the unknown and Goldilocks","volume":"22","author":"Padayatty","year":"2016","journal-title":"Oral Dis"},{"key":"2025082707104328000_15.5.e249711.10","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.12099"},{"key":"2025082707104328000_15.5.e249711.11","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2004.10.025"},{"key":"2025082707104328000_15.5.e249711.12","doi-asserted-by":"publisher","DOI":"10.1016\/s0272-6386(12)80111-9"},{"key":"2025082707104328000_15.5.e249711.13","doi-asserted-by":"crossref","DOI":"10.1186\/s12882-019-1311-4","article-title":"The effect of increased frequency of hemodialysis on vitamin C concentrations: an ancillary study of the randomized frequent hemodialysis network (FHN) daily trial","volume":"20","author":"Raimann","year":"2019","journal-title":"BMC Nephrol"},{"key":"2025082707104328000_15.5.e249711.14","unstructured":"Vitamin C. 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