Sex differences in pediatric HAPE
Objective: To explore sex differences in pediatric High Altitude Pulmonary Edema (HAPE)
Methods: We performed a retrospective chart review in children who presented to Children’s Hospital Colorado from 2004-2014 with a clinical diagnosis consistent with HAPE and a chest radiograph consistent with non-cardiogenic pulmonary edema. Descriptive statistics were used to describe the demographics, presentations, treatment strategies, and follow-up.
Results: From 2004 to 2014, 50 children met criteria for HAPE. Median age at presentation was 10.2 years (range 0.6-19 years). Thirty patients had classic HAPE, 19 patients had re-entry HAPE, and one had high altitude resident pulmonary edema. Most (72%) patients were male. This sex difference was most notable in children older than 11 years of age (p = 0.004) and was driven by children with classic HAPE (p = 0.007) rather than re-entry HAPE (p = .25).
Conclusions: HAPE appears to be more common in post-pubescent males. Further studies should be done to confirm this sex difference, to determine if female sex hormones are protective against HAPE or male sex hormones are a risk factor for HAPE, and to explore underlying mechanisms to better inform treatment.