CASE REPORT article
Front. Physiol.
Sec. Respiratory Physiology and Pathophysiology
Re-ascent Triggered High Altitude Pulmonary and Cerebral Edema in a Tibetan with Pre-existing High-Altitude Polycythemia: A Case Report
Provisionally accepted
- 1Department of Neurology, People's Liberation Army Joint Logistics Support Force 940th Hospital, Lanzhou, China
- 2Department of Respiratory, Affiliated Fukang Hospital of Tibet University, Lhasa, China
- 3Department of Preventive Medicine, Tibet University, Lhasa, China
- 4Department of Critical Care Medicine, The 940th Hospital of Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou, China
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High-altitude pulmonary edema (HAPE), high-altitude cerebral edema (HACE), and high-altitude polycythemia (HAPC) are each rarely observed in Tibetan populations. The coexistence of HAPE, HACE, and HAPC in the same person has not been previously documented. Here, we report the case of a native Tibetan male with HAPC who developed both HAPE and HACE upon re-ascent to an altitude of 3,650 m after a 27-day stay at low altitude. On the 3rd-4th day post-return, the patient exhibited persistent dyspnea, chest tightness, hypersomnia, intermittent agitation, and confusion. Chest CT and multimodal neuroimaging confirmed the presence of HAPE and HACE. Treatment followed guidelines (supplemental oxygen, high-dose dexamethasone) along with supportive measures, resulting in clinical resolution. This is the first reported case of co-occurring HAPE, HACE and HAPC in a native Tibetan upon re-ascent, suggesting that pre-existing HAPC may be a significant risk factor for severe acute high-altitude illness in this setting.
Keywords: high-altitude cerebral edema, High-altitude polycythemia, high-altitude pulmonary edema, re-ascent, susceptibility, tibetan population
Received: 04 Sep 2025; Accepted: 17 Dec 2025.
Copyright: © 2025 Huang, Yuan, Zhang, Song, Xue, Liu and Cao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: He Huang
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