{"title":"Vitamin C Deficiency Megaloblastic Anemia Mimicking Hemolytic Anemia.","authors":"Kaito Sano, Naoto Imoto, Haruki Koketsu, Atsushi Kubo, Rie Ito, Marie Nakashima, Shingo Kurahashi","doi":"10.2169/internalmedicine.5013-24","DOIUrl":null,"url":null,"abstract":"<p><p>A 31-year-old female presented at our hospital with fatigue and subcutaneous bleeding. Blood tests revealed hemolytic anemia. The patient had Coombs-negative normocytic anemia and thrombocytopenia; therefore, thrombotic thrombocytopenic purpura was ruled out. On day two, we noticed that the eating habits of the patient, hypersegmented neutrophils, and megaloblastic changes suggested malnutrition; therefore, we initiated vitamin supplementation. On day six, the vitamin C levels were <0.2 μg/mL, and the patient was therefore diagnosed with scurvy. Scurvy can mimic hemolytic anemia by causing normocytic megaloblastic anemia with a high reticulocyte count. Hypersegmented neutrophils and a detailed medical history are important for making a differential diagnosis.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"3140-3145"},"PeriodicalIF":1.0000,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659941/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Internal Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2169/internalmedicine.5013-24","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/26 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
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Abstract
A 31-year-old female presented at our hospital with fatigue and subcutaneous bleeding. Blood tests revealed hemolytic anemia. The patient had Coombs-negative normocytic anemia and thrombocytopenia; therefore, thrombotic thrombocytopenic purpura was ruled out. On day two, we noticed that the eating habits of the patient, hypersegmented neutrophils, and megaloblastic changes suggested malnutrition; therefore, we initiated vitamin supplementation. On day six, the vitamin C levels were <0.2 μg/mL, and the patient was therefore diagnosed with scurvy. Scurvy can mimic hemolytic anemia by causing normocytic megaloblastic anemia with a high reticulocyte count. Hypersegmented neutrophils and a detailed medical history are important for making a differential diagnosis.
期刊介绍：
Internal Medicine is an open-access online only journal published monthly by the Japanese Society of Internal Medicine.
Articles must be prepared in accordance with "The Uniform Requirements for Manuscripts Submitted to Biomedical Journals (see Annals of Internal Medicine 108: 258-265, 1988), must be contributed solely to the Internal Medicine, and become the property of the Japanese Society of Internal Medicine. Statements contained therein are the responsibility of the author(s). The Society reserves copyright and renewal on all published material and such material may not be reproduced in any form without the written permission of the Society.
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