Monge's disease

Monge's Disease

Monge's Disease, also known as Chronic Mountain Sickness (CMS), is a medical condition that affects individuals living at high altitudes. It is characterized by an excessive production of red blood cells, leading to increased blood viscosity and a range of symptoms that can affect the quality of life.

Pathophysiology

Monge's Disease is primarily caused by chronic hypoxia, which is a deficiency in the amount of oxygen reaching the tissues. At high altitudes, the atmospheric pressure is lower, resulting in reduced oxygen availability. In response, the body produces more red blood cells to increase the oxygen-carrying capacity of the blood. However, in some individuals, this compensatory mechanism becomes excessive, leading to polycythemia, or an abnormally high concentration of red blood cells.

The increased blood viscosity can lead to complications such as:

• Pulmonary hypertension
• Right ventricular hypertrophy
• Cerebral hypoxia

Symptoms

The symptoms of Monge's Disease can vary but often include:

• Headaches
• Dizziness
• Fatigue
• Sleep disturbances
• Cyanosis (bluish discoloration of the skin)
• Dyspnea (shortness of breath)

Diagnosis

Diagnosis of Monge's Disease involves a combination of clinical evaluation and laboratory tests. Key diagnostic criteria include:

• Hemoglobin concentration greater than 21 g/dL in men and 19 g/dL in women
• Hematocrit levels above 65%
• Symptoms consistent with chronic hypoxia

Additional tests may include:

• Arterial blood gas analysis
• Echocardiography to assess heart function
• Pulmonary function tests

Treatment

The primary treatment for Monge's Disease is descent to a lower altitude, which can alleviate symptoms by increasing oxygen availability. Other treatment options include:

• Phlebotomy to reduce red blood cell mass
• Acetazolamide to improve oxygenation
• Supplemental oxygen therapy

In some cases, medications such as calcium channel blockers may be used to manage pulmonary hypertension.

Epidemiology

Monge's Disease is most commonly observed in populations living at altitudes above 2,500 meters (8,200 feet), such as the Andes in South America and the Himalayas in Asia. It predominantly affects adults who have lived at high altitudes for extended periods.

History

The condition was first described by Dr. Carlos Monge Medrano in 1925, who observed the symptoms in high-altitude populations in the Andes. His work laid the foundation for understanding the physiological adaptations and maladaptations to high-altitude living.

Also see

• High-altitude pulmonary edema
• High-altitude cerebral edema
• Acute mountain sickness
• Polycythemia