Publication: Joint Effusions And Purpura In Multiply-Transfused Adult Beta-Thalassemia- Clinical Pointers To Diagnosis Of Scurvy
Date
2013
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Periodic transfusions and effective chelation have ensured that thalassemics survive
in to adulthood but their life is punctuated by peculiar problems in adulthood.
Three cases of scurvy are being reported presenting uniquely as purpura, right hip
joint effusion and right knee joint effusion with haemorrhage in prepatellar and
retropatellar bursae, respectively over an 18 month period (2009-2010). The first
two cases did give a history of gum bleed. None had any coagulation disturbance
or transfusion-transmitted infections or connective tissue disorder. All the three
cases responded dramatically to vitamin C supplementation. It is imperative to
keep in mind that recurrent blood transfusions are associated with a state of sub-
clinical vitamin C deficiency and overt scurvy may manifest as cumulative number
of transfusions increase, as in adult thalassemics.
KEYWORDS
Joint effusion, scurvy, thalassemia, transfusion-dependent, ascorbic acid, vitamin C
Description
Prakash A, Pandey AK
Department of Medicine
Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital, New Delhi, India