Chronic Mountain Sickness

To the Editor:I read with interest the case report by Klepper et al,1Klepper M Barnard P Eschenbacher W A case of chronic mountain sickness diagnosed by routine pulmonary function tests.Chest. 1991; 100: 823-825Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar which appeared in the September 1991 issue of Chest. I have some questions regarding that case of chronic mountain sickness. Why did the patient require tracheostomy? What was the long-term follow-up with oxygen therapy or with moving to sea level? I note that the PaCO2 fell from 66 mm Hg to 60 mm Hg over one week. Was this the onset of a clinical response to a low-altitude environment?In a similar case, which I reported in Chest in 1984,2Gronbeck III, C Chronic mountain sickness at an elevation of 2,000 meters.Chest. 1984; 85: 577-578Crossref PubMed Scopus (3) Google Scholar respiratory acidosis resolved over two months with oxygen therapy at altitude and then relocation to sea level. Polycythemia improved without phlebotomy over six months. Clinical improvement at sea level is usual in chronic mountain sickness and is one feature that establishes the diagnosis. To the Editor: I read with interest the case report by Klepper et al,1Klepper M Barnard P Eschenbacher W A case of chronic mountain sickness diagnosed by routine pulmonary function tests.Chest. 1991; 100: 823-825Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar which appeared in the September 1991 issue of Chest. I have some questions regarding that case of chronic mountain sickness. Why did the patient require tracheostomy? What was the long-term follow-up with oxygen therapy or with moving to sea level? I note that the PaCO2 fell from 66 mm Hg to 60 mm Hg over one week. Was this the onset of a clinical response to a low-altitude environment? In a similar case, which I reported in Chest in 1984,2Gronbeck III, C Chronic mountain sickness at an elevation of 2,000 meters.Chest. 1984; 85: 577-578Crossref PubMed Scopus (3) Google Scholar respiratory acidosis resolved over two months with oxygen therapy at altitude and then relocation to sea level. Polycythemia improved without phlebotomy over six months. Clinical improvement at sea level is usual in chronic mountain sickness and is one feature that establishes the diagnosis. Chronic Mountain SicknessCHESTVol. 101Issue 6PreviewTo the Editor: Full-Text PDF