Reversible right-sided heart failure and pulmonary hypertension caused by scurvy in a 7-year-old boy with autism spectrum disorder and a review of the literature

Paediatr Int Child Health. 2023 Nov;43(4):95-99. doi: 10.1080/20469047.2021.1901406. Epub 2021 May 25.

Abstract

Scurvy, a condition caused by vitamin C deficiency, is rare, especially in high-income countries. Symptoms of scurvy are typically characterised by dermatological disorders such as poor wound healing and tooth loss, but there is not usually cardiac involvement. A case of reversible pulmonary hypertension and right-sided heart failure owing to scurvy in a 7-year-old boy with autism spectrum disorder is reported. He had a very restricted diet and presented with polyarthralgia, gingival hyperplasia with ecchymosis, and fatigue. His condition, including pulmonary hypertension and right-sided heart failure, completely resolved with vitamin C supplementation. Paediatricians should have a high index of suspicion for scurvy in children with nutritional selectivity and be aware that it can manifest with cardiac symptoms. Scurvy may be life-threatening if not treated, but the symptoms can improve rapidly with vitamin C supplementation.

Keywords: Pulmonary hypertension; autism spectrum disorder; iron deficiency; right-sided heart failure; vitamin C deficiency.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Ascorbic Acid / therapeutic use
  • Autism Spectrum Disorder* / complications
  • Autism Spectrum Disorder* / diagnosis
  • Child
  • Heart Failure* / complications
  • Heart Failure* / etiology
  • Humans
  • Hypertension, Pulmonary* / diagnosis
  • Hypertension, Pulmonary* / drug therapy
  • Hypertension, Pulmonary* / etiology
  • Male
  • Scurvy* / complications
  • Scurvy* / diagnosis
  • Scurvy* / drug therapy

Substances

  • Ascorbic Acid