[Chinese expert consensus on the diagnosis and treatment of high-altitude polycythemia(2025)].

Abstract

High-altitude polycythemia (HAPC) is defined as a secondary excessive erythrocytosis caused by prolonged exposure to hypoxic environments at altitudes above 2, 500 meters, characterized primarily by significantly elevated hemoglobin levels (≥210 g/L in males and ≥190 g/L in females). Clinically, HAPC manifests as headache, fatigue, sleep disturbances, and is prone to complications such as thrombosis and organ damages. To standardize the diagnosis and treatment of HAPC in China, the Red Blood Cell Disease Group, Hematology Branch of Chinese Medical Association formulated this consensus based on extensive expert consultation, integrating the latest evidence-based findings and practical experience in high-altitude medicine. The consensus delineates a stratified therapeutic strategy: mild cases are managed with low-flow oxygen therapy; moderate cases require combined pharmacological and oxygen therapy; and severe cases are recommended for erythrocytapheresis as the primary intervention, supplemented by pharmacotherapy and oxygen support.