Gastrointestinal Bleeding Secondary to Scurvy in an Alcoholic Malnourished Cirrhotic Patient

On physical examination, his conjunctivae were pale, and he had severe periodontitis with gingival hypertrophy and purplish areas consistent with necrosis (Figure 1). His skin revealed follicular hyperkeratosis, and his legs were hairless (Figure 2). Laboratory blood tests showed hemoglobin 7.1 g/L, mean corpuscular volume 104.7 f/L, white blood cell count 11.4 x 10/L, platelets 89 x 10/L, international normalized ratio 1.83, total bilirubin 3.5 mg/dL, albumin 2.9 g/dL, creatinine 0.89 mg/dL, magnesium 1.1mg/dL, calcium7.7mg/dL,phosphorus2.0mg/dL, ferritin 10ng/mL, transferrin56mg/dL,vitaminB92.1ng/mL,vitamin B12 582 pg/mL, and vitamin C 0.14 mg/dL. Colonoscopy showed multiple intramucosal hemorrhages in the cecum and