Ebert-Santos, Christine. High-altitude
pulmonary edema in mountain community residents. High Alt Med Biol. 18:278-284, 2017.-High-altitude
pulmonary edema (HAPE) affects lowlanders ascending quickly to elevations above 2440 m. Mountain resident children with no travel can sometimes develop HAPE as was observed over 30 years ago (Fasules et al., 1985). This is not well known and children instead are diagnosed as having
pneumonia or
asthma. In our clinic at 2800 m, we see children presenting with severe
hypoxemia, clinical, and radiographic findings consistent with HAPE despite no recent travel. We call this mountain resident HAPE. We reviewed records of 48 patients with pulmonary symptoms. Analysis included vital signs, pulse oximetry, laboratories, physical findings, and
clinical course. We identified 33 residents with HAPE and no travel, five with reentry HAPE, two visitors with classic HAPE, six residents with
pneumonia, and two with
asthma. Also, 48 X-rays on hypoxemic children seen between 2006 and 2017 were reviewed. Five showed definite HAPE with follow-up X-rays within 48 hours confirming rapid clearing on
oxygen, 27 showed findings consistent with HAPE or
viral pneumonia and no repeat study. Children living at elevation presenting with
hypoxemia are commonly misdiagnosed. Rapid improvement with
oxygen and little to no improvement with
bronchodilators are more consistent with HAPE, and thus,
antibiotics and other treatments can be avoided.