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A 43-year-old man was admitted with a three-week history of general malaise, dysphagia, chronic cough, nausea, and a feeling of fullness after eating. He had undergone a Whipple procedure in the past because of a chronic inflammatory mass in the head of the pancreas. He was unkempt and cachectic. He had a widespread hemorrhagic rash on his legs (Panel A), perifollicular and conjunctival hemorrhages, periorbital ecchymoses (Panel B), purpura, and marked dependent edema. The plasma vitamin C level was less than 0.02 mg per deciliter (1.0 µmol per liter; normal value, >0.56 mg per deciliter [32 µmol per liter]). The . . . [Full Text of this Article] |
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