Medical Conditions and High-Altitude Travel

To the Editor: Luks and Hackett (Jan. 27 issue)(1) recommend that the best way for high-risk patients to assess their tolerance to high-altitude exposure is to travel to a ski-resort community in Colorado. Such resorts are generally located at altitudes between 2500 and 3000 m. The issue for persons with sickle cell disease is that hypobaric hypoxemia precipitates hemoglobin sickling and secondary complications, including vaso-occlusive crises, splenic sequestration, and stroke. According to Table 2 in the article by Luks and Hackett, persons with sickle cell disease would be exempt from this recommendation, but the table implies that travel to lower . . .