{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T17:30:14Z","timestamp":1786728614781,"version":"build-2736575974"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Scurvy, the disease state caused by ascorbic acid deficiency, was once an extremely common disease but is now thought to be a rare disease in postmodern societies. Physicians are not trained to consider scurvy as a possible diagnosis in patients at risk; rather, it is considered a rare diagnosis to add to a differential for completeness\u2019s sake.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We sought to describe the scorbutic patients seen by one physician during a busy academic emergency medicine career. Case series of patients seen by one physician between 1993 and 2023 at five academic teaching hospitals with Emergency Departments (EDs) in the mid-Eastern United States. Presenting signs and symptoms, known scurvy risk factors, Vitamin C levels, clinical course, and outcome for each patient are described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were 14 presentations by 12 patients diagnosed with scurvy who were initially evaluated in the ED between 1993 and 2023. Each patient had a known risk factor for inadequate Vitamin C intake. All had clinical findings suggestive of scurvy and all but one had a subnormal serum Vitamin C level detected on serum samples sent from the ED.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The detection of 12 cases of scurvy by one physician over a three-decade period highlights the importance of screening for scurvy in at-risk populations and generates the hypothesis that scurvy is not a rare disease but rather a rare diagnosis. This research hypothesis should be investigated in further studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jets.jets_108_23","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T04:00:49Z","timestamp":1709265649000},"page":"53-57","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Scurvy: A Rare Disease or a Rare Diagnosis?"],"prefix":"10.4103","volume":"17","author":[{"given":"David F.","family":"Gaieski","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,2,28]]},"reference":[{"key":"R1-20260506","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1056\/NEJM198604033141407","article-title":"New concepts in the biology and biochemistry of ascorbic acid","volume":"314","author":"Levine","year":"1986","journal-title":"N Engl J Med"},{"key":"R2-20260506","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1056\/NEJM197907123010204","article-title":"The biosynthesis of collagen and its disorders (second of two parts)","volume":"301","author":"Prockop","year":"1979","journal-title":"N Engl J Med"},{"key":"R3-20260506","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1001\/jama.281.15.1415","article-title":"Criteria and recommendations for Vitamin C intake","volume":"281","author":"Levine","year":"1999","journal-title":"JAMA"},{"key":"R5-20260506","doi-asserted-by":"crossref","first-page":"16","DOI":"10.3945\/an.113.005157","article-title":"Vitamin C","volume":"5","author":"Lykkesfeldt","year":"2014","journal-title":"Adv Nutr"},{"key":"R8-20260506","first-page":"609","article-title":"Severe scurvy; a clinical and hematologic study","volume":"31","author":"Vilter","year":"1946","journal-title":"J Lab Clin Med"},{"key":"R9-20260506","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1056\/NEJM198608213150808","article-title":"Case records of the Massachusetts general hospital. 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