Abstract
This is the first case report of a Japanese boy who suffered from reentry high altitude pulmonary edema (reentry HAPE). A 10 year-old Japanese boy moved from Japan to 3,400 meters (La Paz, Bolivia). He had lived in La Paz without symptoms for 10 months. Pulmonary edema occurred 17 hours after returning home from a short stay at low altitude. He was initially diagnosed with a common cold, but later diagnosed with reentry HAPE and treated with oxygen, intravenous dexamethasone, and oral acetazolamide. Therapeutic descent by flight was cancelled, as he improved and returned to school five days after the onset of symptoms. Reentry HAPE occurs when residents at high altitude return home after traveling to low altitude locations. Rate of reentry HAPE is higher in children than in adults. In this case, reentry HAPE occurred for the first time after the patient had traveled to low altitude locations three previous times. Contributing factors might be viral respiratory infection, insomnia, and excessive exercise. Misdiagnosis of reentry HAPE may result in death. Even if residents at high altitude are accustomed to traveling to low altitude, they and their medical providers should be aware of the symptoms and treatment of reentry HAPE.
