Serum immunoreactive erythropoietin in high altitude natives with and without excessive erythrocytosis

We report the estimation of blood hemoglobin (Hb), arterial blood oxygen saturation (SaO₂), and serum immunoreactive erythropoietin (siEPO) in a group of Peruvian workers residing in Cerro de Pasco at 4300 m showing 'excessive erythrocytosis' (EE, Monge's disease, chronic mountain sickness). These estimates were compared with those of humans residing either in Cerro de Pasco and showing 'normal erythrocytosis' (NE) or in Lima (sea level, SL) to determine whether Hb and SaO₂ are related to siEPO in high altitude (HA) natives with NE or EE. The three parameters showed statistically significant differences between HA and SL groups - the values in SL being lower. Significant differences were also found between NE and EE groups in Hb and SaO₂. There was no statistical difference in siEPO between the two groups. The results indicate, therefore, that HA residents who develop EE are not distinguishable from residents who develop NE on the basis of estimates of siEPO. As a result, siEPO and Hb do not show a dose-response relationship in HA residents, and variation in EPO does not explain the striking variation in Hb at high altitudes.