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Case Reports: Rare disease
Scurvy-induced pulmonary arterial hypertension
  1. Jehad Azar1,
  2. Mohammed Ayyad2,
  3. Yasmin Jaber3 and
  4. Laith Azzam Ayasa2
  1. 1Pulmonary and Critical Care Department, Cleveland Clinic Foundation, Cleveland, Ohio, USA
  2. 2Internal Medicine Department, Al Quds University, Abu Dis, State of Palestine
  3. 3Oncology, Georgetown University, Washington, DC, USA
  1. Correspondence to Dr Jehad Azar; jehad.azar{at}gmail.com

Abstract

Pulmonary arterial hypertension (PAH) is a progressive disease of the pulmonary vasculature that results in precapillary pulmonary hypertension. PAH is caused by a group of clinical conditions involving multiple organ systems. Several cases have been reported in the literature demonstrating an association between vitamin C deficiency and PAH. Low endothelial nitric oxide levels in the pulmonary vasculature, combined with the inappropriate activation of hypoxia-inducible transcription factors, seen in patients with ascorbic acid deficiency, are believed to be the main contributors to the pathogenesis of pulmonary vasculopathy and the exaggerated pulmonary vasoconstrictive response seen in patients with scurvy-induced PAH. Vitamin C supplementation is considered the definitive treatment.

  • Medical management
  • Pulmonary hypertension
  • Respiratory medicine
  • Malnutrition
  • Vitamins and supplements

https://doi.org/10.1136/bcr-2023-254730

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    Footnotes

    • Contributors JA, MA, YJ and LAA contributed in the preparation and revision of this manuscript. JA: patient diagnosis and management, collection and assembly of data, manuscript writing and editing, literature revision and review, final approval of manuscript, accountable for all aspects of the work. MA: manuscript writing and editing, literature revision and review, final approval of manuscript, accountable for all aspects of the work. YJ: manuscript writing and editing, literature revision and review, final approval of manuscript, accountable for all aspects of the work. LAA: manuscript writing and editing, literature revision and review, final approval of manuscript, accountable for all aspects of the work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • © BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.