Urinary leukotriene E4 levels in high-altitude pulmonary edema: A possible role for inflammation

David A. Kaminsky, Ken Jones, Robert B. Schoene, Norbert F. Voelkel

Research output: Contribution to journalArticlepeer-review

42 Scopus citations


Study objectives: Inflammation may contribute to the pathogenesis of high-altitude pulmonary edema (HAPE). This study was designed to determine whether a marker of inflammation, urinary leukotriene E4 (LTE4), is elevated in patients with HAPE. Design: We conducted a case-control study to collect clinical data and urine samples from HAPE patients and healthy control subjects at moderate altitude (≤2727 m), and follow-up urine samples from HAPE patients following their return to low altitude (≤1,600 m). Setting: Five medical clinics in Summit County, Colorado. Patients: Questionnaire data were evaluated in 71 HAPE patients and 36 control subjects. Urinary LTE4 levels were determined from a random subset of 38 HAPE patients and 10 control subjects presenting at moderate altitude, and on 5 HAPE patients who had returned to low altitude. Measurements and results: Using an enzyme immunoassay technique, urinary LTE4 levels were found to be significantly higher in HAPE patients (123 [16 to 468] pg/mg creatinine, geometric mean [range]) than in control subjects (69 [38 to 135]), p=0.02. Following return to low altitude, urinary LTE4 levels fell significantly from 122 (41.8 to 309) to 53.6 (27.6 to 104) pg/mg creatinine (p=0.05). Urinary LTE4 levels were not related to age, sex, time at altitude, physical condition or habitual exercise, recent use of alcohol or nonsteroidal anti- inflammatory drugs (NSAIDs), or oxygen saturation. Clinical factors associated with HAPE included male sex, regular exercise, and recent use of NSAIDs. Conclusions: We conclude that urinary LTE4 levels are elevated in patients with HAPE, supporting the view that HAPE involves inflammatory mechanisms.

Original languageEnglish (US)
Pages (from-to)939-945
Number of pages7
Issue number4
StatePublished - Jan 1 1996
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine


  • high altitude
  • inflammation
  • leukotrienes
  • nonsteroidal anti-inflammatory drugs
  • pulmonary edema

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