scholarly journals Reevaluation of excessive erythrocytosis in diagnosing chronic mountain sickness in men from the world’s highest city

Blood ◽  
2020 ◽  
Vol 136 (16) ◽  
pp. 1884-1888 ◽  
Author(s):  
Laura Oberholzer ◽  
Carsten Lundby ◽  
Emeric Stauffer ◽  
Mathilde Ulliel-Roche ◽  
Ivan Hancco ◽  
...  

The diagnosis of chronic mountain sickness (CMS) is based on a score including 7 clinical features (breathlessness, sleep disturbance, cyanosis, venous dilatation, paresthesia, headache, and tinnitus) in the setting of extreme erythrocytosis. Examining individuals in La Rinconada, Peru, the highest city in the world, the authors demonstrated that CMS at extreme altitude is not linked to elevation of hemoglobin, since CMS+ and CMS− individuals had similar levels of erythrocytosis.

2021 ◽  
Author(s):  
Zhiqi Gao ◽  
Shenwei Xie ◽  
Wenxiang Gao ◽  
Jun Yin ◽  
Bing Ni ◽  
...  

Abstract BackgroundChronic mountain sickness (CMS), is a common disease occurred to people who migrate to plateau. Current CMS studies in different periods or areas have poor comparability due to the inconsistent diagnosis methods. Here we carried out a comparative study of the CMS prevalence in the year 2019 and 2009, to provide evidence for the prevention and diagnosis of CMS. Methods The Qinghai CMS Scoring System (Qinghai standard) was used to investigate the subjects who lived for at least months in the 3300-5400 m altitude area in 2019 and 2009, respectively. Their prevalence and symptom scores were also analyzed and statistically compared.ResultsThe prevalence of CMS in 2019 survey subjects (15.60%) was significantly lower than that in 2009 (31.18%). The prevalence of dyspnea, venous dilatation, paresthesia, headache, tinnitus, and hemoglobin concentration reached 21g/dL or above decreased significantly among the survey subjects in 2019. The scores of cyanosis, venous dilatation, paresthesia, and headache significantly decreased in the 2019 survey subjects. But among the CMS patients, the sleep disturbance scores of the 2019 survey subjects increased significantly. ConclusionCompared to 2009, the health level of high altitude living population in 2019 has been significantly improved, indicating that the sleep research on high-altitude living population and the application of high altitude oxygen therapy has been effective in the past ten years. Among the CMS associated symptoms, sleep disturbance is an important indicator for the prevention and diagnosis of CMS, which deserves special attention.


2020 ◽  
Vol 11 ◽  
Author(s):  
Ivan Hancco ◽  
Sébastien Bailly ◽  
Sébastien Baillieul ◽  
Stéphane Doutreleau ◽  
Michèle Germain ◽  
...  

CHEST Journal ◽  
2021 ◽  
Author(s):  
Benoit Champigneulle ◽  
Ivan Hancco ◽  
Etienne Hamard ◽  
Stéphane Doutreleau ◽  
Michael Furian ◽  
...  

2019 ◽  
Author(s):  
Ivan Hancco ◽  
Sébastien Bailly ◽  
Sébastien Baillieul ◽  
Stéphane Doutreleau ◽  
Michèle Germain ◽  
...  

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 661.1-661
Author(s):  
Y. Sun ◽  
L. Ma ◽  
H. Chen ◽  
C. Rongyi ◽  
L. Jiang

Background:Hypertension occurred in 30-80% of TAK patients around the world. The occurrence of hypertension might severely worsen TAK prognosis. Nevertheless, data describing the specific imaging features in hypertensive TAK patients and the associations between hypertensive severity, blood pressure control status and long-term outcome were still lacking.Objectives:To investigate the characteristics and associations of hypertensive characteristics with adverse events-free survival in Takayasu arteritis (TAK) patients with hypertension.Methods:This research was based on a prospectively on-going observational cohort-East China Takayasu Arteritis (ECTA) cohort. In all, 618 TAK patients, who registered in the ECTA cohort up to December 2019, were enrolled. The main outcome was the adverse-events-free survival among hypertensive TAK patients during the follow-up ended on August 2020.Results:Totally, 204 (33.0%) patients suffered from hypertension, with 48 (23.5%), 62 (30.4%), and 94 (46.1%) mild, moderate, and severe hypertension, respectively. Cluster analysis indicated three imaging phenotypes for hypertensive TAK patients: Cluster 1: involvement of the abdominal aorta and/or renal artery (n=56, 27.5%); Cluster 2: involvement of the ascending aorta, thoracic aorta, and the aortic arch and its branches (n=38, 18.6%); Cluster 3: combined involvement of Cluster 1 and Cluster 2 (n=111, 54.4%). By the end of the follow-up, the blood pressure control rate was 50.8%, while the adverse-events-free survival was 67.9% in the entire hypertensive population. Multivariate Cox regression analysis indicated that well-controlled blood pressure (HR=2.13, 95%CI 1.32–3.78, p=0.047), co-existence of severe aortic valve regurgitation (HR=0.87, 95%CI 0.64–0.95, p=0.043), Cluster 1 (HR=0.69, 95%CI 0.48–0.92, p=0.017) and Cluster 3 (HR=0.72, 95%CI 0.43–0.94, p=0.048) imaging phenotype was associated with the adverse-events-free survival.Conclusion:Patients with controlled hypertension showed better adverse-events-free survival, while those with the Cluster 1 imaging phenotype were more likely to suffer from worse adverse-events-free survival. Hypertension occurred in 30-80% of TAK patients around the world. The occurrence of hypertension might severely worsen TAK prognosis.References:[1]Johnston SL, Lock RJ, Gompels MM. Takayasu arteritis: a review. J Clin Pathol 2002; 55:481–6.[2]Watanabe Y, Miyata T, Tanemoto K. Current clinical features of new patients with Takayasu arteritis observed from a cross-country research in Japan: age and sex specificity. Circulation 2015; 132:1701–9.[3]Yilmaz N, Can M, Oner FA, et al. Impaired quality of life, disability and mental health in Takayasu’s arteritis. Rheumatol. (Oxford) 2013; 52:1898–904.[4]Laurent A, Julien H, Nicolas L, et al. Takayasu arteritis in France: a single-center retrospective study of 82 cases comparing white, North African, and black patients. Medicine 2010; 89:1–17.[5]Mwipatayi BP, Jeffery PC, Beningfield SJ, et al. Takayasu arteritis: clinical features and management: report of 272 cases. ANZ J Surg 2005; 75:110–7.Disclosure of Interests:None declared


Author(s):  
Andrew R. Steele ◽  
Michael M. Tymko ◽  
Victoria L. Meah ◽  
Lydia L Simpson ◽  
Christopher Gasho ◽  
...  

The high-altitude maladaptation syndrome known as chronic mountain sickness (CMS) is characterized by polycythemia and is associated with proteinuria despite unaltered glomerular filtration rate. However, it remains unclear if indigenous highlanders with CMS have altered volume regulatory hormones. We assessed N-terminal pro-B-type natriuretic peptide (NT pro-BNP), plasma aldosterone concentration, plasma renin activity, kidney function (urinary microalbumin, glomerular filtration rate), blood volume, and estimated pulmonary artery systolic pressure (ePASP), in Andean males without (n=14; age=39±11) and with (n=10; age=40±12) CMS at 4330 meters (Cerro de Pasco, Peru). Plasma renin activity (non-CMS: 15.8±7.9 vs. CMS: 8.7±5.4 ng/ml; p=0.025) and plasma aldosterone concentration (non-CMS: 77.5±35.5 vs. CMS: 54.2±28.9 pg/ml; p=0.018) were lower in highlanders with CMS compared to non-CMS, while NT pro-BNP was not different between groups (non-CMS: 1394.9±214.3 vs. CMS: 1451.1±327.8 pg/ml; p=0.15). Highlanders had similar total blood volume (non-CMS: 90±15 vs. CMS: 103±18 ml • kg-1; p=0.071), but Andeans with CMS had greater total red blood cell volume (non-CMS: 46±10 vs. CMS 66±14 ml • kg-1; p<0.01) and smaller plasma volume (non-CMS 43±7 vs. CMS 35±5 ml • kg-1; p=0.03) compared to non-CMS. There were no differences in ePASP between groups (non-CMS 32±9 vs. CMS 31±8 mmHg; p=0.6). A negative correlation was found between plasma renin activity and glomerular filtration rate in both groups (group: r=-0.66; p<0.01; non-CMS: r=-0.60; p=0.022; CMS: r=-0.63; p=0.049). A smaller plasma volume in Andeans with CMS may indicate an additional CMS maladaptation to high-altitude, causing potentially greater polycythemia and clinical symptoms.


Author(s):  
Ingrid Asmussen ◽  
Luciano Bernardi ◽  
Peter Bärtsch ◽  
Tom Hornbein ◽  
Fabiola Leon-Velarde ◽  
...  

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