Ferreira Carolina Cavalcanti Gonçalves, de Sá Pereira Belfort Deborah, Neto Paulo Miranda Cavalcante, Gouveia Pedro Alves da Cruz
Internal Medicine Service, Federal University of Pernambuco, Recife, Brazil.
Heart Institute (InCor), University of São Paulo, São Paulo, Brazil.
Eur J Case Rep Intern Med. 2020 Jan 10;7(2):001404. doi: 10.12890/2020_001404. eCollection 2020.
Pulmonary hypertension (PH) can be related to several diseases, such as connective tissue disorders and pulmonary embolism, or to drugs; it may also be idiopathic. Few cases have been reported demonstrating an association between ascorbic acid deficiency and reversible PH. We report the case of a patient who arrived at the emergency department with dyspnoea, tachycardia and lower limb perifollicular haemorrhage. Examinations, including a transthoracic echocardiogram, revealed enlarged right chambers and an estimated pulmonary artery systolic pressure of 61 mmHg. Further evaluation revealed poor food intake due to paranoid personality disorder, leading to ascorbic acid deficiency and manifestations of scurvy.
Diagnosing ascorbic acid deficiency is important as associated pulmonary hypertension could be completely resolved with appropriate treatment.Ascorbic acid deficiency is a condition that can still be found in many countries, including developed ones.Patients suffering from psychiatric disorders are at high risk of scurvy.
肺动脉高压（PH）可与多种疾病相关，如结缔组织病和肺栓塞，或与药物有关；也可能是特发性的。很少有病例报告显示维生素C缺乏与可逆性PH之间存在关联。我们报告一例患者，该患者因呼吸困难、心动过速和下肢毛囊周围出血而到急诊科就诊。包括经胸超声心动图在内的检查显示右心房扩大，估计肺动脉收缩压为61mmHg。进一步评估发现，由于偏执型人格障碍导致食物摄入不足，进而引起维生素C缺乏和坏血病表现。
诊断维生素C缺乏很重要，因为相关的肺动脉高压通过适当治疗可能完全缓解。维生素C缺乏在包括发达国家在内的许多国家仍然可以发现。患有精神疾病的患者患坏血病的风险很高。
