Vitamin C deficiency can lead to pulmonary hypertension: a systematic review of case reports

BMC Pulmonary Medicine

Table 1 Characteristics of the patients in the case reports and the findings

Study [ref]	Country	Age (y)	Sex	Neuro-psychiatric disorders	mPAP		Ratio ( mPAP pre/post )	Benefit on cardiac outcomes (days)^a
					diagnosis (mmHg)	repeat ( mmHg)
Vitamin C alone (16 cases)^b
Abbas (2016) [76]	USA	50	F	Anxiety	^c			28
Abe (2021) [77]	USA	7	M	ASD	46	22	2.1	38
Azar (2023) [79]	USA	35	F	Anxiety	41			21
Conte (2021) [81]	USA	48	F	Anxiety	35
Ferreira (2020) [84]	Brazil	51	M	Paranoid	39
Ghulam Ali (2018) [87]	Italy	66	M		61	19	3.2	14
Gilmore (2021) [88]	USA	22	M	ASD	32	12	2.8	42
Kurnick (2023) [91]	USA	25	F		45	24	2.0
Mehta (1996) [92]	USA	40	F	Anorexia	36			19
Mertens (2011) [93]	USA	74	F	Food delusions	51			150
Nagamatsu (2009) [94]	USA	73	F		48	23	2.1	90
Petersen (2019) [97]	USA	5	M	ASD	^c			14
Shah (2021) [101]	USA	35	F	Anxiety	54	19	2.9	14
Singh (2017) [102]	USA	48	F		41			30
Tan (2021) [103]	Malaysia	7	M	ASD	48	14	3.4	10
Valencia (2022) [105]	USA	19	M		76	33	2.3
Vitamin C with other vitamins or minerals (15 cases)
Benhamed (2019) [80]	France	40	M		63	19	3.3	2
Dean (2018) [82]	USA	6	M		43	14	3.2	2
Duvall (2013) [83]	USA	9	M	ASD	45			9
Frank (2019) [85]	USA	17	M		51	22	2.3	30
Gayen (2020) [86]	USA	60	M		41	20	2.1	150
Ichiyanagi (2019) [89]	Japan	3	M	ASD	77	19	4.1	1
Kupari (2012) [90]	Finland	40	F		48	15	3.2	7
Nariai (2022) [95]	Japan	2	F		54	21	2.5	2
Penn (2019) [96]	USA	48	F		41	26	1.6	42
Quinn (2022) [98]	USA	6	M	ASD	42	21	2.0	9
Ratanachu (2003a) [99]	Thailand	2	M		^c			7
Ratanachu (2003b) [99]	Thailand	3	M		^c			7
Sakamornchai (2022a) [100]	Thailand	6	M	ASD	57			60
Sakamornchai (2022b) [100]	Thailand	5	M	ASD	57			1
Ueki (2022) [104]	Japan	11	M	ASD	29	23	1.2	105
Vitamin C was not administered (1 case)
Azar (2019) [78]	USA	73	F		50			Died

This table summarizes the data collected in Supplements 1 and 2
ASD Autism spectrum disorder
^aMany studies reported only a late repeat echocardiograph. Late benefit does not indicate that the effect of vitamin C necessarily was slow. For example, Mertens (2011) [93] stated that a repeat echocardiography was carried out after 5 months, but there is no information about the cardiac status before the 5-month time point. See a survival curve of the effect of vitamin C on cardiac outcomes in Fig. S2
^bVitamin C alone indicates that no other vitamins or minerals were administered. Many patients in this group were administered drugs for PAH. However, no PAH drugs were administered for the patients reported in Abbas (2016) [76], Abe (2021) [77], Ferreira (2020) [84], Gilmore (2021) [88], Mehta (1996) [92], and Shah (2021) [101]
^cFour case reports stated that PH was demonstrated, but no mPAP estimate is available. They are not shown in Fig. 1

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