{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T13:34:45Z","timestamp":1793885685653,"version":"4.8.0"},"reference-count":21,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"vor","delay-in-days":268,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Respiratory Medicine Case Reports"],"published-print":{"date-parts":[[2026]]},"DOI":"10.1016\/j.rmcr.2026.102509","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T15:30:25Z","timestamp":1790436625000},"page":"102509","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Vitamin C deficiency presenting with mucosal bleeding and worsening dyspnea in severe pulmonary arterial hypertension: a case report"],"prefix":"10.1016","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2639-3138","authenticated-orcid":false,"given":"Lucy","family":"Tarcha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Elwing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Elwing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.rmcr.2026.102509_bib1","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.3390\/nu12072008","article-title":"Global vitamin C status and prevalence of deficiency: a cause for concern?","volume":"12","author":"Rowe","year":"2020","journal-title":"Nutrients"},{"key":"10.1016\/j.rmcr.2026.102509_bib2","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.01887-2018","article-title":"Pathology and pathobiology of pulmonary hypertension: state of the art and research perspectives","volume":"53","author":"Humbert","year":"2019","journal-title":"Eur. Respir. J."},{"key":"10.1016\/j.rmcr.2026.102509_bib3","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.00879-2022","article-title":"2022 ESC\/ERS guidelines for the diagnosis and treatment of pulmonary hypertension","volume":"61","author":"Humbert","year":"2023","journal-title":"Eur. Respir. J."},{"key":"10.1016\/j.rmcr.2026.102509_bib4","first-page":"1736","article-title":"Vitamin C status of US adults assessed as part of the National Health and Nutrition Examination Survey remained unchanged between 2003\u20132006 and 2017\u20132018","volume":"15","author":"Carr","year":"2023","journal-title":"Nutrients"},{"key":"10.1016\/j.rmcr.2026.102509_bib5","doi-asserted-by":"crossref","DOI":"10.1016\/j.clnu.2026.106601","article-title":"Scurvy, an enduring mimicker and diagnostic dilemma in adults: a review of the 280 relevant published cases in the twenty-first century","volume":"59","author":"Rivi\u00e8re","year":"2026","journal-title":"Clin. Nutr."},{"key":"10.1016\/j.rmcr.2026.102509_bib6","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.1016\/j.chest.2019.06.043","article-title":"Vitamin C deficiency-induced pulmonary arterial hypertension","volume":"157","author":"Gayen","year":"2020","journal-title":"Chest"},{"key":"10.1016\/j.rmcr.2026.102509_bib7","article-title":"Vitamin C deficiency as a readily reversible cause of pulmonary hypertension","volume":"30","author":"Flanagan","year":"2025","journal-title":"JACC Case Rep."},{"key":"10.1016\/j.rmcr.2026.102509_bib8","doi-asserted-by":"crossref","first-page":"5638","DOI":"10.1172\/JCI137558","article-title":"Hypoxia-inducible factor signaling in pulmonary hypertension","volume":"130","author":"Pullamsetti","year":"2020","journal-title":"J. Clin. Investig."},{"key":"10.1016\/j.rmcr.2026.102509_bib9","doi-asserted-by":"crossref","first-page":"45","DOI":"10.7150\/ijms.88216","article-title":"Expression and regulation of HIF-1\u03b1 in hypoxic pulmonary hypertension: focus on pathological mechanism and pharmacological treatment","volume":"21","author":"Wan","year":"2024","journal-title":"Int. J. Med. Sci."},{"key":"10.1016\/j.rmcr.2026.102509_bib10","doi-asserted-by":"crossref","first-page":"5619","DOI":"10.1113\/JP284591","article-title":"Oxygen-sensing pathways and the pulmonary circulation","volume":"602","author":"Slingo","year":"2024","journal-title":"J. Physiol."},{"key":"10.1016\/j.rmcr.2026.102509_bib11","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2022.898827","article-title":"Vitamin C deficiency reveals developmental differences between neonatal and adult hematopoiesis","volume":"13","author":"Phadke","year":"2022","journal-title":"Front. Immunol."},{"key":"10.1016\/j.rmcr.2026.102509_bib12","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1007\/s12185-018-02575-w","article-title":"Vitamin C deficiency: rare cause of severe anemia with hemolysis","volume":"109","author":"Shaikh","year":"2019","journal-title":"Int. J. Hematol."},{"key":"10.1016\/j.rmcr.2026.102509_bib13","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1186\/s12890-024-02941-x","article-title":"Vitamin C deficiency can lead to pulmonary hypertension: a systematic review of case reports","volume":"24","author":"Hemil\u00e4","year":"2024","journal-title":"BMC Pulm. Med."},{"key":"10.1016\/j.rmcr.2026.102509_bib14","article-title":"When a diet is followed too strictly. Scurvy\u2014An old disease in a modern gut: a case report","volume":"104","author":"Guarino","year":"2025","journal-title":"Medicine (Baltim.)"},{"key":"10.1016\/j.rmcr.2026.102509_bib15","first-page":"375","article-title":"Scurvy: an unexpected nutritional complication in an adolescent female with anorexia nervosa","volume":"66","author":"Roy-Lavallee","year":"2020","journal-title":"J. Adolesc. Health"},{"key":"10.1016\/j.rmcr.2026.102509_bib16","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.bcmd.2019.01.004","article-title":"Scurvy, an old story in a new time: the hematologist's experience","volume":"76","author":"Khalife","year":"2019","journal-title":"Blood Cells Mol. Dis."},{"key":"10.1016\/j.rmcr.2026.102509_bib17","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1002\/ncp.10800","article-title":"High-dose vitamin C therapy for symptomatic deficiency in a patient with myasthenia gravis and Crohn's disease","volume":"37","author":"Murphree","year":"2022","journal-title":"Nutr. Clin. Pract."},{"key":"10.1016\/j.rmcr.2026.102509_bib18","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1111\/ijd.14832","article-title":"Revisiting the pathobiology of scurvy: a review of the literature in the context of a challenging case","volume":"59","author":"Deirawan","year":"2020","journal-title":"Int. J. Dermatol."},{"key":"10.1016\/j.rmcr.2026.102509_bib19","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1111\/adj.12889","article-title":"Scurvy: the almost forgotten disease\u2014a case report","volume":"67","author":"Manzie","year":"2022","journal-title":"Aust. Dent. J."},{"key":"10.1016\/j.rmcr.2026.102509_bib20","doi-asserted-by":"crossref","first-page":"3140","DOI":"10.2169\/internalmedicine.5013-24","article-title":"Vitamin C deficiency megaloblastic anemia mimicking hemolytic anemia: a case report","volume":"64","author":"Sano","year":"2025","journal-title":"Intern. Med."},{"key":"10.1016\/j.rmcr.2026.102509_bib21","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.nut.2018.10.009","article-title":"Vitamin C for the critically ill: is the evidence strong enough?","volume":"60","author":"Berger","year":"2019","journal-title":"Nutrition"}],"container-title":["Respiratory Medicine Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2213007126001462?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2213007126001462?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T13:14:22Z","timestamp":1793884462000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2213007126001462"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":21,"alternative-id":["S2213007126001462"],"URL":"https:\/\/doi.org\/10.1016\/j.rmcr.2026.102509","relation":{},"ISSN":["2213-0071"],"issn-type":[{"value":"2213-0071","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Vitamin C deficiency presenting with mucosal bleeding and worsening dyspnea in severe pulmonary arterial hypertension: a case report","name":"articletitle","label":"Article Title"},{"value":"Respiratory Medicine Case Reports","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.rmcr.2026.102509","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"102509"}}