Xiang Chu-Han, Zhang Xi-Mu, Liu Jie, Xiang Jun, Li Lei, Song Qing
Department of Cardiology, The Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China.
Department of Cardiology, The 71 Group Army Hospital of CPLA Army, Xuzhou 221000, Jiangsu Province, China.
World J Radiol. 2024 Oct 28;16(10):545-551. doi: 10.4329/wjr.v16.i10.545.
Exertional heat stroke (EHS) is a critical condition arising from prolonged physical exertion in high temperatures that typically presents with normal hemoglobin levels. However, atypical presentations can also occur, leading to significant complications such as hemolytic anemia and organ dysfunction.
This case report describes a male patient who experienced moderate-to-severe anemia that was difficult to correct, with a confirmed diagnosis of microangiopathic hemolytic anemia accompanying multiple organ dysfunction syndrome, indicative of critical EHS. Despite intensive resuscitation efforts, the patient's condition deteriorated, necessitating admission to the intensive care unit for advanced management.
This case highlights the importance of recognizing atypical presentations of EHS, particularly that with significant hemolytic anemia and concurrent organ failure. Clinicians should maintain a high level of suspicion for these complications in patients displaying symptoms of heat-related illness, especially when caused by strenuous activity, as early diagnosis and intervention are crucial to improve patient outcomes.
劳力性热射病（EHS）是在高温环境下长时间体力活动引发的危急病症，通常血红蛋白水平正常。然而，也可能出现非典型表现，导致严重并发症，如溶血性贫血和器官功能障碍。
本病例报告描述了一名男性患者，其患有难以纠正的中重度贫血，确诊为伴有多器官功能障碍综合征的微血管病性溶血性贫血，提示为重症EHS。尽管进行了强化复苏努力，患者病情仍恶化，需要入住重症监护病房进行高级管理。
本病例突出了认识EHS非典型表现的重要性，尤其是伴有严重溶血性贫血和并发器官衰竭的情况。临床医生应对出现热相关疾病症状的患者，特别是由剧烈活动引起的患者，对这些并发症保持高度怀疑，因为早期诊断和干预对于改善患者预后至关重要。
