Reversible pulmonary hypertension in a patient diagnosed with scurvy

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.