title: Are heat stroke and physical exhaustion underestimated causes of acute hepatic failure?
abstract: While cardiopulmonary symptoms are common in patients undergoing classical or, due to physical exercise, exertional heat stroke, the failure of other organs is a rarely described phenomenon. Here we present two cases of acute hepatic failure, one due to classic heat shock, while the other occurred while the patient was doing a marathon-type running. Both cases presented with very high transaminases and significantly elevated international normalized ratio (INR). No other causes for liver failure could be identified but physical exhaustion and hyperthermia.
authors.affiliation: Department of Gastroenterology and Hepatology, Medicine IV, University of Heidelberg, 69120 Heidelberg, Germany. kilian.weigand@med.uni-heidelberg.de
authors.forename: Kilian
authors.initials: K
authors.lastname: Weigand
authors.forename: Carina
authors.initials: C
authors.lastname: Riediger
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Stremmel
authors.forename: Christa
authors.initials: C
authors.lastname: Flechtenmacher
authors.forename: Jens
authors.initials: J
authors.lastname: Encke
mesh_terms: D000328:Adult; D001663:Bilirubin / Q000652:urine; D003404:Creatinine / Q000652:urine; D004798:Enzymes / Q000097:blood; D005221:Fatigue / Q000150:complications*; D018883:Heat Stroke / Q000150:complications*; D006801:Humans; D008099:Liver / Q000473:pathology; D017114:Liver Failure, Acute / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged
chemical_list: D004798:Enzymes; D003404:Creatinine; D001663:Bilirubin