Mozzini Chiara, Xotta Giovanni, Garbin Ulisse, Fratta Pasini Anna Maria, Cominacini Luciano
Department of Medicine, Section of Internal Medicine, University of Verona, Verona, Italy.
Am J Case Rep. 2017 Oct 4;18:1058-1065. doi: 10.12659/ajcr.905701.
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.
中暑（HS）是一种危及生命的病症，其特征为核心体温升高至40°C以上、中枢神经系统功能障碍以及可能出现的多器官衰竭。中暑可引发全身炎症、弥散性血管内凝血（DIC）、横纹肌溶解、脑水肿和癫痫发作、肺水肿、心脏功能障碍以及肾和肝功能衰竭。病例报告：我们报告一例41岁罗马尼亚女性病例，该女性有酗酒史，于2016年6月乘巴士抵达意大利维罗纳后发生中暑。患者出现了连续性多器官功能障碍，包括肝和肾功能衰竭、横纹肌溶解、弥散性血管内凝血和心律失常。患者通过保守治疗成功治愈。17天后，她完全康复。结论：中暑相关多器官功能障碍的确切机制尚未完全明确，其发病机制复杂。它涉及炎症、氧化应激、内质网（ER）应激和线粒体功能障碍。建立一个慢性酒精滥用改变氧化、炎症和内质网应激反应的模型，对于严重中暑患者（其中肝功能衰竭起主要作用）的良好预后来说，也可能是一种可行办法。
