A Peculiar Case of Purpura

      A 40-year old man with a history of bipolar disorder and obsessive-compulsive disorder came to the Emergency Department because of general weakness, edema, and purpura on his lower extremities. His past medical history was unremarkable: he did not take any medication, did not suffer from allergies, and, besides his psychiatric background, he mentioned only an episode of self-limited diarrhea 2 years earlier, without pathological findings on colonoscopy. At that time he decided to live on a diet of oats, canned tuna, and eggs, because he believed he was allergic to fructose. Two weeks prior to his admission, he consulted a general practitioner, who, due to anemia and folic acid deficiency, prescribed a multivitamin preparation together with folic acid tablets.
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