{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:27:38Z","timestamp":1791203258895,"version":"4.2.0"},"reference-count":7,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:p>We report 4 children (aged 3\u20139\u00a0years) with severe pulmonary hypertension (PH) associated with vitamin C deficiency. All presented with either musculoskeletal symptoms or cardiorespiratory deterioration with peripheral edema. Multiple nutritional deficiencies were identified in all children, and 2 had autistic spectrum disorder. Initial echocardiography results demonstrated severe PH with right ventricular dysfunction and significantly elevated N-terminal pro-B-type natriuretic peptide levels. In 2 patients presenting with musculoskeletal symptoms, specialist radiologic review revealed subtle features of scurvy that provided early diagnostic clues before laboratory confirmation. Vitamin C levels were undetectable where samples were processed prior to replacement, highlighting the importance of securing viable samples before treatment initiation for diagnostic certainty. All children received vitamin C replacement therapy, with 3 also receiving concurrent sildenafil. Remarkably, all demonstrated rapid clinical and echocardiographic improvement following vitamin C initiation, with complete resolution within 3\u00a0months. Importantly, 1 child receiving sildenafil alone showed no therapeutic response until vitamin C was added, indicating that improvement requires correction of the underlying deficiency rather than pulmonary vasodilation alone. This case series demonstrates rapid reversibility of vitamin C deficiency-associated PH and emphasizes the importance of considering this diagnosis in children with restricted diets and unexplained PH.<\/jats:p>","DOI":"10.1542\/peds.2025-073645","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:02:17Z","timestamp":1773705737000},"source":"Crossref","is-referenced-by-count":2,"title":["Pulmonary Hypertension Associated With Vitamin C Deficiency Is Rapidly Reversible"],"prefix":"10.1542","volume":"157","author":[{"given":"Tom\u00e1s","family":"Woodgate","sequence":"first","affiliation":[{"name":"1National Paediatric Pulmonary Hypertension Service, Great Ormond Street Hospital, London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Patel","sequence":"additional","affiliation":[{"name":"2Paediatric Cardiology Department, Royal Hospital for Children, Glasgow"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Day","sequence":"additional","affiliation":[{"name":"3Paediatric Cardiology Department, Evelina London Children\u2019s Hospital, London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brodie","family":"Knight","sequence":"additional","affiliation":[{"name":"2Paediatric Cardiology Department, Royal Hospital for Children, Glasgow"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriani","family":"Spanaki","sequence":"additional","affiliation":[{"name":"3Paediatric Cardiology Department, Evelina London Children\u2019s Hospital, London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alistair","family":"Calder","sequence":"additional","affiliation":[{"name":"4Radiology Department, Great Ormond Street Hospital, London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahin","family":"Moledina","sequence":"additional","affiliation":[{"name":"1National Paediatric Pulmonary Hypertension Service, Great Ormond Street Hospital, London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadia","family":"Quyam","sequence":"additional","affiliation":[{"name":"1National Paediatric Pulmonary Hypertension Service, Great Ormond Street Hospital, London"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"2026071612565708000_r1","doi-asserted-by":"crossref","first-page":"928026","DOI":"10.3389\/fnut.2022.928026","article-title":"Case report: vitamin C combined with multiple micronutrient deficiencies is associated with pulmonary arterial hypertension in children with autistic spectrum disorder","volume":"9","author":"Sakamornchai","year":"2022","journal-title":"Front 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