Reentry High-Altitude Pulmonary Edema in Pediatric Patients

High-altitude pulmonary edema (HAPE) occurs when a person without adequate pulmonary adaptation ascends above 2500 meters above sea level. Usually, it is more frequent among those living at low altitudes, however, it can occur in people who live at high altitudes and descend to lower ones for a short time, which is called re-entry HAPE. Objective: To describe the clinical course, diagnosis, and management of re-entry HAPE in pediatric patients, and to achieve an early approach to reduce complications. Clinical Cases: We present 6 cases of pediatric patients diagnosed with re-entry HAPE in a fourth level hospital in Bogota, Colombia, between 2013 and 2018. All patients resided in Bogota, 5/6 were male, the median age was 11 years, 4/6 had a history of lung disease, and 5/6 required a high-flow oxygen device. In all cases, the chest X-ray reported opacities and 2/6 showed pulmonary hypertension on the echocardiogram. All patients were initially treated for bacterial pneumonia or asthma and, although they progressed adequately, these inadequate treatments can cause complications. Conclusion: The diagnosis, treatment, and prevention of HAPE are important since it is usually confused with infectious pulmonary pathologies due to its similar clinical course, which leads to inadequate treatment and can generate complications. The suggestion is that HAPE should be considered as a differential diagnosis in patients with a recent history of ascending to high altitude cities.