• Chest · Jul 2012

    Case Reports

    Reversible pulmonary hypertension associated with vitamin C deficiency.

    • Markku Kupari and Janne Rapola.
    • Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. Markku.Kupari@hus.fi
    • Chest. 2012 Jul 1;142(1):225-7.

    AbstractWe describe the case of a 40-year-old female patient who developed severe pulmonary hypertension and life-threatening right-sided heart failure in association with dietary scurvy and iron deficiency. Supplementation with oral vitamin C and iron very likely contributed to her complete cure. Scurvy-associated pulmonary arterial hypertension could result from impaired availability of endothelial nitric oxide, but inappropriate activation of the hypoxia-inducible family (HIF) of transcription factors could play an even more important role. HIF coordinates the body's responses to hypoxia, and its activity is regulated by oxygen-dependent prolyl hydroxylases, which need vitamin C and iron as cofactors. Deficiency of these cofactors could lead to uncontrolled HIF activity and pulmonary vasoconstriction responsive to vitamin C and iron administration.

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