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.
Dr William Lee and colleagues from Texas, USA described cases of acute liver injury or failure caused by heat stroke in a large acute liver failure registry.
Amongst 2675 consecutive subjects enrolled in a prospective observational cohort of patients with acute liver injury or acute liver failure between 1998 and 2015, there were 8 subjects with heat stroke.
|7 patients developed acute kidney injury|
The team found that 5 patients had acute liver failure, and 3 had acute liver injury.
The researchers noted that 7 patients developed acute kidney injury, all 8 had lactic acidosis and rhabdomyolysis.
There were 6 patients that underwent cooling treatments, 3 received N-acetyl cysteine, 3 required mechanical ventilation, 3 required renal replacement therapy, 2 received vasopressors, 1 underwent liver transplantation, and 2 patients died—both within 48 hours of presentation.
The team observed that all cases occurred between May and August, mainly in healthy young men because of excessive exertion.
Dr Lee's team concludes, "Management of acute liver injury and acute liver failure secondary to heat stroke should focus on cooling protocols and supportive care, with consideration of liver transplantation in refractory patients."