Gregory Berra, Léon Genecand, Anais Juillet, Jean-François Deux, Paco Prada, Hajo Müller, Marco Roffi, Maurice Beghetti
Geneva University Hospitals.
Switzerland
British Medical Journal Case Reports
BMJ Case Rep 2025; 18:
DOI: 10.1136/bcr-2025-266143
Abstract
This case report describes a woman in her late 50s with reversible pulmonary hypertension (PH) due to scurvy, a rare vitamin C (ascorbic acid) deficiency in the context of a long-standing eating disorder. The patient presented with cachexia, severe dyspnoea, fatigue and oedema. Initial tests showed pre-capillary PH with significantly reduced cardiac output (CO), while investigations ruled out common PH causes. Nutritional evaluation revealed a severe deficiency in vitamin C and mild vitamin B1 deficiency. Treatment with oral vitamin supplementation, diuretics and psychiatric support led to rapid improvement. Within a week, pulmonary pressures and CO normalised, and the patient’s clinical symptoms improved. This case underscores the importance of considering nutritional deficiencies, like vitamin C deficiency, in unexplained PH, especially in patients with malnutrition or eating disorders. It emphasises the need for comprehensive diagnostic approaches and adherence to international PH management guidelines to identify and treat reversible causes of PH.
Category
Class V. Pulmonary Hypertension Associated with Hematological, Systemic, Metabolic, Nutritional and Other Disorders
Medical Therapy. Efficacy or Lack of Efficacy
Age Focus: Adult Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes