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World J Gastroenterol. Jan 14, 2007; 13(2): 306-309
Published online Jan 14, 2007. doi: 10.3748/wjg.v13.i2.306
Published online Jan 14, 2007. doi: 10.3748/wjg.v13.i2.306
Are heat stroke and physical exhaustion underestimated causes of acute hepatic failure?
Kilian Weigand, Carina Riediger, Wolfgang Stremmel, Jens Encke, Department of Gastroenterology and Hepatology, Medicine IV, University of Heidelberg, 69120 Heidelberg, Germany
Christa Flechtenmacher, Department of Pathology, University of Heidelberg, 69120 Heidelberg, Germany
Author contributions: All authors contributed equally to the work.
Correspondence to: Kilian Weigand, Universitaetsklinikum Heidelberg, Medizin IV, Abteilung fuer Gastroenterologie, Im Neuenheimer Feld 410, Heidelberg D-69120, Germany. kilian.weigand@med.uni-heidelberg.de
Telephone: +49-6221-5638747 Fax: +49-6221-565361
Received: April 28, 2006
Revised: July 25, 2006
Accepted: October 27, 2006
Published online: January 14, 2007
Revised: July 25, 2006
Accepted: October 27, 2006
Published online: January 14, 2007
Abstract
While cardiopulmonary symptoms are common in patients undergoing classical or, due to physical exercise, exertional heat stroke, the failure of other organs is a rarely described phenomenon. Here we present two cases of acute hepatic failure, one due to classic heat shock, while the other occurred while the patient was doing a marathon-type running. Both cases presented with very high transaminases and significantly elevated international normalized ratio (INR). No other causes for liver failure could be identified but physical exhaustion and hyperthermia.
Keywords: Heat stroke; Acute hepatic failure; Heat shock; Liver failure; Hyperthermia