Alveolar haemorrhage in a case of high altitude pulmonary oedema
- aDivision of Respiratory, Critical Care, and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA, bNora Eccles Harrison Cardiovascular Research and Training Institute, cDepartment of Pediatrics, dMedicine Service, Veterans Affairs Medical Center, Salt Lake City, Utah 84112, USA, ePulmonary and Critical Care Division in the Department of Internal Medicine, LDS Hospital, Salt Lake City, Utah 84143, USA
- Dr C K Grissom, Pulmonary and Critical Care Division, LDS Hospital, 325 8th Avenue, Salt Lake City, Utah 84143, USA
- Received 27 October 1997
- Revision requested 13 January 1998
- Revised 16 March 1998
- Accepted 29 April 1998
Abstract
A case of high altitude pulmonary oedema (HAPE) in a climber who made a rapid ascent on Mt McKinley (Denali), Alaska is described. The bronchoalveolar lavage (BAL) fluid contained increased numbers of red blood cells and an abundance of haemosiderin laden macrophages consistent with alveolar haemorrhage. The timing of this finding indicates that alveolar haemorrhage began early during the ascent, well before the onset of symptoms. Although evidence of alveolar haemorrhage has been reported at necropsy in individuals dying of HAPE, previous reports have not shown the same abundance of haemosiderin laden macrophages in the BAL fluid. These findings suggest that alveolar haemorrhage is an early event in HAPE.
- alveolar haemorrhage
- pulmonary oedema
- altitude illness
- acute respiratory distress syndrome (ARDS)
- high altitude
Footnotes
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This work was supported by awards from the Wilderness Medical Society, the Nora Eccles Treadwell Foundation, the Richard A and Nora Eccles Harrison Fund for Cardiovascular Research, and by a National Institutes of Health Special Center of Research in ARDS (HL 50153).
