{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:46:17Z","timestamp":1790279177997,"version":"4.1.0"},"reference-count":8,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"unspecified","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,11,6]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>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\u2019s 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.<\/jats:p>","DOI":"10.1136\/bcr-2025-266143","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T09:45:11Z","timestamp":1764927911000},"page":"e266143","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Reversible pulmonary hypertension in a patient diagnosed with scurvy"],"prefix":"10.1136","volume":"18","author":[{"given":"Gregory","family":"Berra","sequence":"first","affiliation":[{"name":"Respirology, Geneva University Hospitals, Geneva, Switzerland"},{"name":"Pulmonary Hypertension Program, Geneva University Hospitals, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e9on","family":"Genecand","sequence":"additional","affiliation":[{"name":"Respirology, Geneva University Hospitals, Geneva, Switzerland"},{"name":"Pulmonary Hypertension Program, Geneva University Hospitals, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anais","family":"Juillet","sequence":"additional","affiliation":[{"name":"Internal medicine, Geneva University Hospitals, Geneva, GE, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Deux","sequence":"additional","affiliation":[{"name":"Radiology, Geneva University Hospitals, Geneva, GE, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paco","family":"Prada","sequence":"additional","affiliation":[{"name":"Psychiatry, Geneva University Hospitals, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajo","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension Program, Geneva University Hospitals, Geneva, Switzerland"},{"name":"Cardiology, Geneva University Hospitals, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Roffi","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension Program, Geneva University Hospitals, Geneva, Switzerland"},{"name":"Cardiology, Geneva University Hospitals, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice","family":"Beghetti","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension Program, Geneva University Hospitals, Geneva, Switzerland"},{"name":"Pediatric Cardiology, Geneva University Hospitals, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"2025120501450483000_18.12.e266143.1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00879-2022"},{"key":"2025120501450483000_18.12.e266143.2","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2023-254730","article-title":"Scurvy-induced pulmonary arterial hypertension","volume":"16","author":"Azar","year":"2023","journal-title":"BMJ Case Rep"},{"key":"2025120501450483000_18.12.e266143.3","doi-asserted-by":"crossref","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":"2025120501450483000_18.12.e266143.4","doi-asserted-by":"crossref","DOI":"10.1016\/j.jaccas.2025.103424","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":"2025120501450483000_18.12.e266143.5","doi-asserted-by":"crossref","DOI":"10.1016\/j.jaccas.2024.102222","article-title":"An Unusual Etiology of Severe Right Heart Failure Deserving of Wider Recognition","volume":"29","author":"Kang","year":"2024","journal-title":"JACC Case Rep"},{"key":"2025120501450483000_18.12.e266143.6","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2025.1478889","article-title":"Case Report: severe pulmonary hypertension in a child with micronutrient deficiency","volume":"13","author":"Pache-Wannaz","year":"2025","journal-title":"Front Pediatr"},{"key":"2025120501450483000_18.12.e266143.7","article-title":"Pulmonary hypertension secondary to vitamin C deficiency: A case report","volume":"123","author":"Silberkasten","year":"2025","journal-title":"Arch Argent Pediatr"},{"key":"2025120501450483000_18.12.e266143.8","doi-asserted-by":"crossref","DOI":"10.1186\/s13052-025-02014-7","article-title":"Scurvy, all the faces you can see: our experience and review of the literature","volume":"51","author":"Toscano","year":"2025","journal-title":"Ital J Pediatr"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-266143","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T09:45:12Z","timestamp":1764927912000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-266143"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":8,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,5]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bcr-2025-266143"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-266143","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}