Erythropoietin is KNOWN to have an .. "adverse effect" .. OF ..
cough .. and erythropoietin is KNOWN to rise when one goes to
altitude .
Could it BE .. increased red blood cell production .. ?
Pulmonary Pharmacology & Therapeutics
Volume 20, Issue 4, August 2007, Pages 388-395
Special Issue: Fourth International Symposium on Cough
doi:10.1016/j.pupt.2006.10.018
Copyright © 2006 Elsevier Ltd All rights reserved.
Altitude-related cough
Nicholas P. Masona, , and Peter W. Barryb,
aCritical Care Medicine Directorate, University Hospital of Wales,
Cardiff, UK
bDepartment of Inflammation, Immunology and Immunity, Clinical
Sciences Building, Leicester Royal Infirmary, Leicester, UK
Received 18 September 2006; accepted 30 October 2006. Available
online 16 November 2006.
Abstract
Cough is a troublesome condition which affects many visitors to high
altitude. Traditionally it has been attributed to the inspiration of
the cold, dry air which characterizes the high altitude environment.
This aetiology was brought into question by observations and
experiments in long duration hypobaric chamber studies in which cough
still occurred despite controlled temperature and humidity.
Anecdotally however, exercise, possibly via the associated increase in
ventilation, does appear to precipitate cough at altitude. It is
likely that the term, altitude-related cough, covers a number of
conditions and aetiologies. These aetiologies are discussed and
include water loss from the respiratory tract; high altitude pulmonary
oedema; acute mountain sickness; bronchoconstriction; respiratory
tract infections; vasomotor rhinitis and post-nasal drip; and
alterations in the central control of respiration. We hypothesize that
there are two forms of altitude-related cough: a cough which may occur
at relatively low altitudes and which is related to exercise and
persists despite descent and a cough which does not occur at altitudes
below 5000-6000 m and which improves rapidly with descent to lower
altitude. The treatment of altitude-related cough is symptomatic and
frequently ineffective. Further work is required to understand the
nature and aetiology of the cough which occurs at high altitude before
effective therapies can be developed.
Keywords: Cough; High altitude; Hypobaric hypoxia; Environment
Corresponding author. Tel.: +29 2074 5114/6210.
Pulmonary Pharmacology & Therapeutics
Copyright © 2007 Elsevier B.V. All rights reserved. ScienceDirect® is
a registered trademark of Elsevier B.V.
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