title: Alveolar haemorrhage in a case of high altitude pulmonary oedema.
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.
authors.affiliation: Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
authors.forename: C K
authors.initials: CK
authors.lastname: Grissom
authors.forename: K H
authors.initials: KH
authors.lastname: Albertine
authors.forename: M R
authors.initials: MR
authors.lastname: Elstad
mesh_terms: D000328:Adult; D000532:Altitude Sickness / Q000150:complications* / Q000473:pathology; D001992:Bronchoalveolar Lavage Fluid; D004906:Erythrocyte Count; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D006485:Hemosiderin; D006801:Humans; D016676:Macrophages, Alveolar; D008297:Male; D011650:Pulmonary Alveoli / Q000098:blood supply*; D011654:Pulmonary Edema / Q000209:etiology* / Q000473:pathology
chemical_list: D006485:Hemosiderin