Scurvy, a dietary deficiency disease driven by a deficiency of vitamin C, once a nightmare for sailors, is making a surprising comeback. The rising popularity of weight-loss surgery, combined with the ongoing cost of living crisis, is driving a resurgence of this rare disease, a recent report revealed.

Historically, this deficiency was responsible for claiming the lives of millions of sailors between the 16th and 18th centuries. During that time, sailors lacked regular access to fresh fruits and vegetables containing the essential vitamin. With better access to dietary vitamins from these sources today, scurvy is now considered a rare condition.

In a recent case analysis published in BMJ Case Reports, a man in his early 50s from Perth, Australia, was diagnosed with scurvy after developing a painful rash on his lower limbs. He had hematuria (blood in his urine) and anemia.

The man's medical history revealed that he had undergone bariatric surgery eight years back. After ruling out inflammatory, autoimmune, and blood disorders, the patient was diagnosed with scurvy. The blood tests to check his general nutritional status indicated a severe deficiency of vitamin C and very low levels of other key nutrients.

The patient had a poor diet and had stopped taking the nutritional supplements prescribed for him after previous weight loss surgery due to financial constraints.

"Scurvy is still seen as a disease of the past, especially in developed countries," the researchers wrote. However, with the rising cost of living, the deficiency disease is making a comeback, they cautioned.

"Scurvy is a re-emerging diagnosis in the current era of a rising cost of living and increasing number of bariatric surgeries," the researchers added.

Apart from poor diet, scurvy can also be driven by other risk factors. These include restrictive diets due to allergies, and underlying conditions that hinder vitamin C absorption, such as Crohn's disease and ulcerative colitis, as well as chemotherapy, long-term alcohol use, and smoking.

The symptoms of deficiency begin with fatigue, joint aches, and irritability. When left untreated, it leads to anemia, gum bleeds, loosened teeth, brittle hair, swollen legs, and bleeding under the skin.

"Our patient had multiple risk factors, namely, poor dietary habits, obesity, previous bariatric surgery, use of proton pump inhibitors, and low-income status. His history of iron, vitamin D, and folate deficiencies were also clues to his underlying nutritional deficiency," they concluded.

The patient was treated with ascorbic acid (vitamin C) 1000mg daily, which resolved his painful rash and hematuria.

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