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Acetazolamide: a treatment for chronic mountain sickness
Jean-Paul Richalet1, Maria Rivera, Patrick Bouchet
1Laboratoire EA 2363, UFR SMBH, 74 rue Marcel Cachin, 93017 Bobigny Cedex, France. richalet@smbh.univ-paris13.fr
American Journal of Respiratory and Critical Care Medicine
|August 30, 2005
Summary
Acetazolamide effectively treats chronic mountain sickness by reducing excessive red blood cell production and improving oxygen levels in high-altitude dwellers. This study offers the first pharmacologic treatment for Monge's disease, with potential public health benefits.
Area of Science:
- High-altitude physiology
- Pharmacology
- Hematology
Background:
- Chronic mountain sickness (Monge's disease) affects 5-18% of high-altitude dwellers (>3,200 m) with excessive polycythemia.
- Currently, no pharmacologic treatments are available for this condition.
Purpose of the Study:
- To evaluate the efficacy of acetazolamide in treating chronic mountain sickness.
- To investigate the role of nocturnal hypoxemia in the pathophysiology of Monge's disease.
Main Methods:
- A double-blind, placebo-controlled study involving three groups (n=10 each) from Cerro de Pasco, Peru (4,300 m).
- Participants received either placebo, 250 mg, or 500 mg of acetazolamide orally for three weeks.
Main Results:
- Acetazolamide significantly decreased hematocrit, erythropoietin, and soluble transferrin receptors, while increasing ferritin.
- A 250 mg dose improved nocturnal oxygen saturation, reduced heart rate, and decreased apnea-hypopnea episodes.
- Erythropoietin reduction was linked to increased ventilation and oxygen saturation.
Conclusions:
- Acetazolamide is the first effective, safe pharmacologic treatment for chronic mountain sickness.
- It mitigates hypoventilation, particularly during sleep, and suppresses erythropoiesis.
- Low cost and efficacy suggest significant public health benefits for high-altitude populations.