Multiple Organ Failure Caused by Non-exertional Heat Stroke After Bathing in a Hot Spring

Heat stroke is a life-threatening illness, and the disease spectrum can include the involvement of multiple organs to varying degrees. Rhabdomyolysis with renal function impairment is frequently noted in this disease. However, acute hepatic failure has been rarely reported in non-exertional heat str...

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Bibliographic Details
Published in:Journal of the Chinese Medical Association 2010-04, Vol.73 (4), p.212-215
Main Authors: Lee, Ching-Wei, Perng, Chin-Lin, Huang, Yi-Shin, Luo, Jiing-Chyuan, Hung, Chi-Lai, Lin, Han-Chieh
Format: Article
Language:English
Subjects:
Baths
Dialysis
Fatal Outcome
Heat Stroke - complications
hepatic failure
Hot Springs
Humans
Internal Medicine
Male
Middle Aged
molecular adsorbent recirculating system
multiple organ failure
Multiple Organ Failure - etiology
Multiple Organ Failure - therapy
non-exertional heat stroke
Shock, Septic - etiology
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Summary:Heat stroke is a life-threatening illness, and the disease spectrum can include the involvement of multiple organs to varying degrees. Rhabdomyolysis with renal function impairment is frequently noted in this disease. However, acute hepatic failure has been rarely reported in non-exertional heat stroke. We report a case of acute hepatic failure combined with disseminated intravascular coagulopathy, acute renal failure, and neurological deficit caused by heat stroke after bathing in a hot spring. Molecular adsorbent recirculating system (MARS) treatment was performed daily on days 10–12 of admission. As a result of progressive azotemia, hemodialysis was performed. Unfortunately, after a long course of intensive care, the patient died from septic shock and multiple organ failure. According to available evidence, MARS and hemodialysis are beneficial in treating exertional heat stroke. However, a limited number of studies have treated non-exertional heat-stroke-related acute hepatic failure. Early cooling to reduce the overwhelming heat-stress-related cytokine storm, and advanced MARS to eliminate circulating toxin might have a role in treating this rare but fatal illness.
ISSN:1726-4901
1728-7731
DOI:10.1016/S1726-4901(10)70044-7