title: Therapeutic plasma exchange in the treatment of exertional heat stroke and multiorgan failure.
abstract: BACKGROUND
  Exertional heat stroke (EHS) results in a constellation of systemic inflammatory responses resulting in multiorgan failure and an extremely high mortality.
  We present the case of an 11-year-old obese male who suffered EHS with rhabdomyolysis and concurrent renal, pulmonary, and hepatic failure. Conventional therapies including continuous veno-venous hemodiafiltration (CVVHDF) were ineffective in preventing ongoing deterioration in clinical status. Liver biopsy was reported as "extensive hepatocyte ballooning" and liver-kidney transplantation was tentatively planned.
  
  
  CONCLUSIONS
  The addition of therapeutic plasma exchange using the Prismaflex® system (Gambro, Lakewood, CO, USA) resulted in a reversal of the inflammatory process and recovery from multiorgan failure. Liver biopsy was not a reliable indicator of irreversible hepatic injury.
authors: Department of Pediatrics, Division of Pediatric Nephrology (R-714), University of Miami/Holtz Children's Hospital at Jackson Health System, PO Box 016960, Miami, FL 33101, USA.
authors: Vimal Master Sankar
authors: VM
authors: Raj
authors: Amanda
authors: A
authors: Alladin
authors: Brent
authors: B
authors: Pfeiffer
authors: Chryso
authors: C
authors: Katsoufis
authors: Marissa
authors: M
authors: Defreitas
authors: Alicia
authors: A
authors: Edwards-Richards
authors: Jayanthi
authors: J
authors: Chandar
authors: Wacharee
authors: W
authors: Seeherunvong
authors: Gwenn
authors: G
authors: McLaughlin
authors: Gaston
authors: G
authors: Zilleruelo
authors: Carolyn L
authors: CL
authors: Abitbol
mesh_terms: D002648:Child; D018883:Heat Stroke / Q000628:therapy*; D017583:Hemodiafiltration; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000628:therapy*; D010951:Plasma Exchange