Scurvy Differential Diagnosis

When considering a diagnosis of scurvy, it's essential to evaluate other conditions that may present with similar symptoms. Here's a differential diagnosis organized into categories:

• Single Most Likely Diagnosis

  • Scurvy: This is the most likely diagnosis given the context of the question. Scurvy is caused by a deficiency in vitamin C, leading to symptoms such as fatigue, malaise, and connective tissue defects. A diagnosis of scurvy is justified if the patient has a history of inadequate dietary intake of vitamin C, coupled with clinical findings like perifollicular petechiae, corkscrew hairs, and joint pain.

• Other Likely Diagnoses

  • Vitamin B12 deficiency: This condition can also lead to fatigue, weakness, and neurological symptoms, similar to scurvy. A deficiency in vitamin B12 can cause megaloblastic anemia, which might present with similar nonspecific symptoms.
  • Iron deficiency anemia: While the primary symptom is anemia, iron deficiency can also lead to fatigue, weakness, and poor immune function, overlapping with some symptoms of scurvy.
  • Pellagra: Caused by a deficiency in niacin (vitamin B3), pellagra can lead to dermatitis, diarrhea, dementia, and potentially death if left untreated, sharing some clinical features with scurvy.

• Do Not Miss Diagnoses

  • Leukemia: Certain types of leukemia can cause symptoms similar to scurvy, including fatigue, petechiae, and joint pain. Missing a diagnosis of leukemia could be fatal.
  • Lymphoma: Like leukemia, lymphoma can present with nonspecific symptoms such as fatigue, weight loss, and skin lesions, which could be confused with scurvy.
  • Osteomyelitis or septic arthritis: These infections can cause joint pain and swelling, similar to scurvy. Missing these diagnoses could lead to severe morbidity or mortality.

• Rare Diagnoses

  • Ehlers-Danlos syndrome: A group of disorders that affect connective tissues supporting the skin, bones, blood vessels, and many other organs and tissues. While rare, it could be considered in the differential for scurvy due to overlapping symptoms related to connective tissue defects.
  • Cystic fibrosis: Although primarily known for its respiratory and gastrointestinal manifestations, cystic fibrosis can lead to malabsorption of fat-soluble vitamins, potentially causing deficiencies that might mimic some symptoms of scurvy.
  • Sjögren's syndrome: An autoimmune disorder that can cause a wide range of symptoms, including joint pain and skin rashes, which might be confused with scurvy in some cases.