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04 October 2017 : Case report  Italy

Non-Exertional Heatstroke: A Case Report and Review of the Literature

Challenging differential diagnosis, Unusual or unexpected effect of treatment, Educational Purpose (only if useful for a systematic review or synthesis), Rare coexistence of disease or pathology

Chiara Mozzini1BCDEF*, Giovanni Xotta1BCDE, Ulisse Garbin1BC, Anna Maria Fratta Pasini1BCD, Luciano Cominacini1A

DOI: 10.12659/AJCR.905701

Am J Case Rep 2017; 18:1058-1065

Abstract

BACKGROUND: Heatstroke (HS) is a life-threatening condition characterized by an elevation of the core body temperature above 40°C, central nervous system dysfunction, and possible multi-organ failure. HS can trigger systemic inflammation, disseminated intravascular coagulation (DIC), rhabdomyolysis, cerebral edema and seizures, pulmonary edema, heart dysfunctions, and renal and hepatic failure.

CASE REPORT: We report the case of a 41-year-old Romanian woman with a history of alcoholism who developed HS after arriving by bus in Verona, Italy in June 2016. The patient developed consecutive multi-organ dysfunction, including liver and renal failure, rhabdomyolysis, DIC, and arrhythmia. The patient was successfully treated with conservative measures. After 17 days, she recovered completely.

CONCLUSIONS: The exact mechanism of HS-related multiple organ dysfunction is not completely understood and its pathogenesis is complex. It involves inflammation, oxidative stress, endoplasmic reticulum (ER) stress, and mitochondrial dysfunction. Development of a model in which chronic alcohol abuse alters oxidative, inflammatory, and ER stress response could also be a conceivable solution to the positive prognosis of severe HS patients, in which liver failure has a prominent role.

Keywords: Disseminated Intravascular Coagulation, drug-induced liver injury, Heat Stroke

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923