International Journal of Travel Medicine and Global Health

International Journal of Travel Medicine and Global Health

Chronic Mountain Sickness (Cms) Misdiagnosed As High Altitude Cerebral Edema (Hace) At Extreme Altitude (6400 M/21000 Ft)

Document Type : Case Report

Author
Inam Danish Khan
Clinical Microbiology, Army College of Medical Sciences and Base Hospital, Delhi Cantt 110010, India
10.21859/ijtmgh-040408
Abstract
Introduction: Chronic mountain sickness (CMS) represents a syndrome of secondary polycythemia along with thrombocytopenia, altered hemorheology, pulmonary and systemic hypertension, and congestive heart failure, occurring due to hypobaric hypoxia-anoxia-induced erythropoiesis reported in both native mountain residents and new climbers after prolonged stays at high and extreme altitudes.
Case Presentation: A healthy non-smoker non-drinker reported occipital headache, breathlessness, and insomnia after an uneventful stay of 70 days at 6400 m/21000 ft. His hemoglobin was 21 gm/dL. The patient was diagnosed as having a case of CMS with a Qinghai CMS score >6. Therapeutic phlebotomy was performed; 350 mL was drained on two occasions, reducing his hemoglobin to 14.6 gm/dL.
Conclusion: The altered presentation, difficult diagnosis, evacuation, and long-term management highlighted in this case occurring at 6400 m/21 000 ft in the Karakoram Himalayas represents the insidious nature of altitude sickness in acclimatized subjects.
Keywords
Chronic mountain sickness
Excessive erythrocytosis
Stress polycythemia
Gaisböck syndrome
Cerebral edema
Extreme altitude
Triple hypoxia syndrome
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International Journal of Travel Medicine and Global Health
Volume 4, Issue 4 - Serial Number 15
Autumn 2016
Pages 132-134

  • Receive Date 03 August 2016
  • Revise Date 29 August 2016
  • Accept Date 06 September 2016