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Heat stroke leading to acute liver injury & failure: A case series from the Acute
Liver Failure Study Group
#MMPMID28128878
Davis BC
; Tillman H
; Chung RT
; Stravitz RT
; Reddy R
; Fontana RJ
; McGuire B
; Davern T
; Lee WM
Liver Int
2017[Apr]; 37
(4
): 509-513
PMID28128878
show ga
BACKGROUND & AIMS: In the United States, nearly 1000 annual cases of heat stroke
are reported but the frequency and outcome of severe liver injury in such
patients is not well described. The aim of this study was to describe cases of
acute liver injury (ALI) or failure (ALF) caused by heat stroke in a large ALF
registry. METHODS: Amongst 2675 consecutive subjects enrolled in a prospective
observational cohort of patients with ALI or ALF between January 1998 and April
2015, there were eight subjects with heat stroke. RESULTS: Five patients had ALF
and three had ALI. Seven patients developed acute kidney injury, all eight had
lactic acidosis and rhabdomyolysis. Six patients underwent cooling treatments,
three received N-acetyl cysteine (NAC), three required mechanical ventilation,
three required renal replacement therapy, two received vasopressors, one
underwent liver transplantation, and two patients died-both within 48 hours of
presentation. All cases occurred between May and August, mainly in healthy young
men because of excessive exertion. CONCLUSIONS: Management of ALI and ALF
secondary to heat stroke should focus on cooling protocols and supportive care,
with consideration of liver transplantation in refractory patients.
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