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Abstract
Monge's disease or Chronic Mountain Sickness is characterized by an excessive polycythemia (hemoglobin >21 g/dl in men and >19 g/dl in women) in high-altitude dwellers, with a prevalence of 5-18% above 3200 m. Clinical signs include headache, fatigue, sleep disturbances, dyspnea, dizziness, tinnitus, paresthesia and digestive complains. Pulmonary hypertension is frequently associated, which might lead to congestive heart failure. Hypoxemia due to alveolar hypoventilation may play a central role in the over-stimulation of erythropoiesis leading to increased red cell mass and blood viscosity, systemic and pulmonary hypertension. Acetazolamide is the first efficient pharmacological treatment of Monge's disease without adverse effects, by reducing nocturnal hypoventilation and blunting erythropoiesis. Its low cost might allow a wide development with a considerable positive impact on public health in high-altitude regions. Further studies are necessary to evaluate the prevalence and importance of pulmonary hypertension and its consequences on cardiac function.