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Medline ® Abstract for Reference 48

of 'High altitude disease: Unique pediatric considerations'

Reproducibility of acute mountain sickness in children and adults: a prospective study.
Rexhaj E, Garcin S, Rimoldi SF, Duplain H, Stuber T, Allemann Y, Sartori C, Scherrer U
Pediatrics. 2011;127(6):e1445. Epub 2011 May 2.
OBJECTIVE: Although a history of previous acute mountain sickness (AMS) is commonly used for providing advice and recommending its prophylaxis during subsequent exposure, the intraindividual reproducibility of AMS during repeated high-altitude exposure has never been examined in a prospective controlled study.
METHODS: In 27 nonacclimatized children and 29 adults, AMS was assessed during the first 48 hours after rapid ascent to 3450 m on 2 consecutive occasions 9 to 12 months apart.
RESULTS: During the first exposure, 18 adults (62%) and 6 children (22%) suffered from AMS; during the second exposure, 14 adults (48%) and 4 children (15%) suffered from this problem (adults versus children, P≤.01). Most importantly, the intraindividual reproducibility of AMS was very different (P<.001) between children and adults. None of the 6 children having suffered from AMS during the first exposure suffered from AMS during the second exposure, but 4 children with no AMS during the first exposure did experience this problem during the second exposure. In contrast, 14 of the 18 adults who suffered from AMS on the first occasion also presented with this problem during the second exposure, and no new case developed in those who had not experienced AMS on the first occasion.
CONCLUSIONS: In adults, a history of AMS is highly predictable of the disease on subsequent exposure, whereas in children it has no predictive value. A history of AMS should not prompt practitioners to advise against reexposure to high altitude or to prescribe drugs for its prophylaxis in children.
Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois Lausanne, Switzerland.