Acute liver failure due to heat stroke: A case report
DOI:
https://doi.org/10.59093/27112330.160Keywords:
heat stroke, exertional heat stroke, acute liver failure, multiple organ failureAbstract
Acute liver failure (ALF) is a rare and potentially fatal condition, defined by an international normalized ratio (INR) value ≥1.5, any degree of encephalopathy, a duration of the clinical illness less than 26 weeks, and the absence of previous liver disease. Its causes include heat stroke (HS), a rare entity in which extreme hyperthermia leads to liver involvement. We present the case of a previously healthy 28-year-old man who developed hyperthermia >40 °C, altered consciousness, and hemodynamic collapse after performing intense exercise at high temperatures. Studies showed hepatocellular injury with aminotransferases exceeding twenty times the upper limit of normal, hyperbilirubinemia, coagulopathy with an INR >1.5, and hyperammonemia; findings that, after ruling out other etiologies, led to a diagnosis of hyperacute ALF secondary to HS. Supportive care, including normal-volume plasma exchange, was initiated, resulting in complete recovery without the need for liver transplantation. This case highlights the importance of recognizing HS as a cause of ALF and considering early interventions, including plasmapheresis, within a multidisciplinary approach.
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