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Clove Cigarettes and High-Altitude Pulmonary Edema

Peter H. Hackett, MD; Gil Rodriguez, MD; Robert C. Roach, MS
JAMA. 1985;253(24):3551-3552. doi:10.1001/jama.1985.03350480059015.
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To the Editor.—  Recently, the American Lung Association issued a warning concerning the use of clove cigarettes,1 and the Los Angeles Timesreported on two cases of severe inflammatory iung disease related to clove cigarette use (Dec 4, 1984). The Centers for Disease Control has become concerned and is encouraging reporting of cases. We wish to report here a possible association of clove cigarette lung injury and high-altitude pulmonary edema (HAPE).

Report of a Case.—  A 29-year-old female skier who lived at sea level was brought to the emergency room (elevation, 2,380 m, or 7.800 ft) in extreme respiratory distress. Her history was that over the two days ana nights she had been at high altitude (2,440 to 3.350 m. or 8,000 to 11,000 ft) she had developed a headache, a dry cough, decreased exercise performance, dyspnea on exertion, and, finally, severe dyspnea at


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