Therapeutic Erythrocytapheresis is Effective in Treating 2 Patients with High-Altitude Erythrocythemia.

Abstract

Background: Due to environmental hypoxia on the high-altitude local residents often exhibit a compensative increase in hemoglobin concentration to maintain the body's oxygen supply. In certain people, the number of red blood cells continues to grow, resulting in high altitude polycythemia (HAPC) which is characterized by headache, disorientation, sleeplessness, and bone discomfort. HAPC is often associated with multiple complications, of which lower extremity arteriosclerosis obliterans (LEASO) is rare.

Methods: Here we report two long-term Tibetan male patients living in plateau areas, who were diagnosed with HAPC complicated with LEASO. The diagnostic standards for HAPC are based on the Qinghai score, which is that the patient currently or once lived in high-altitude areas, and the results of conventional blood tests show that hemoglobin Hb > 21 g/dL in males and Hb > 19 g/dL in females. Due to severe complications caused by abnor-mally high hemoglobin levels, they underwent an individualized regimen of therapeutic erythrocytapheresis (TE).

Results: After one TE treatment, both hemoglobin and hematocrit decreased significantly in 2 patients (Hb decreased from 20 g/dL and 21 g/dL to 17.6 g/dL and 18 g/dL in the two patients), alleviating the further deterioration of the disease caused by abnormal erythrocyte elevation.

Conclusions: TE can reduce the hemoglobin and hematocrit of HAPC patients in a timely and effective manner and play a clinical role in alleviating the disease progression of patients to a certain extent, especially for patients with complications. TE needs to be implemented in time.