一例劳力性热射病并发缺氧性肝炎
A Case of Exertional Heat Stroke Complicated by Hypoxic Hepatitis.
作者信息
Woitok Bertram K, Bahmad Shawki, Lindner Gregor
机构信息
Department of General Internal and Emergency Medicine, Buergerspital Solothurn, Solothurn, Switzerland.
出版信息
Case Rep Emerg Med. 2020 Mar 30;2020:8724285. doi: 10.1155/2020/8724285. eCollection 2020.
BACKGROUND
Exertional heat stroke is a life-threatening condition often complicated by multiorgan failure. We hereby present a case of a 25-year-old male presenting with syncope after a 10 km run in 28°C outside temperature who developed acute liver failure. . Initial temperature was found to be 41.1°C, and cooling measures were rapidly applied. He suffered from acute renal failure and rhabdomyolysis and proceeded to acute liver failure (ASAT 6100 U/l and ALAT 6561 U/l) due to hypoxic hepatitis on day 3. He did not meet criteria for emergency liver transplantation and recovered on supportive care.
CONCLUSIONS
Acute liver failure due to heat stroke is a life-threatening condition with often delayed onset, which nevertheless resolves on supportive care in the majority of cases; thus, a delayed referral to transplant seems to be reasonable.
背景
劳力性热射病是一种危及生命的疾病，常并发多器官功能衰竭。我们在此报告一例25岁男性病例，该患者在室外温度28°C下跑完10公里后出现晕厥，随后发展为急性肝衰竭。初始体温为41.1°C，迅速采取了降温措施。他还患有急性肾衰竭和横纹肌溶解症，并在第3天因缺氧性肝炎发展为急性肝衰竭（谷草转氨酶6100 U/l，谷丙转氨酶6561 U/l）。他不符合紧急肝移植标准，经支持治疗后康复。
结论
热射病所致急性肝衰竭是一种危及生命的疾病，发病往往延迟，但在大多数情况下经支持治疗可痊愈；因此，延迟转诊至移植似乎是合理的。
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