Exertional Heat Stroke-Induced Acute Liver Failure and Liver Transplantation

Lin, Jessica; Zaffar, Duha; Muhammad, Haris; Ting, Peng–Sheng; Woreta, Tinsay A.; Kim, Amy; Kohli, Ruhail; Oshima, Kiyoko; Cameron, Andrew M.; Philosophe, Benjamin; Ottmann, Shane; Wesson, Russell; Gürakar, Ahmet

doi:10.14309/crj.0000000000000820

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…Renal failure is a common complication of heatstroke that is mainly manifested as tubular necrotizing acute renal failure and can be caused by massive protein deposition in the renal tubular epithelial cells after hemolysis and rhabdomyolysis (13,21,(158)(159)(160)(161)(162)(163)(164)(165)(166). Liver dysfunction in patients with heatstroke and in animal models is considerably common, with the liver injury mainly occurring in the recovery period of heatstroke (167)(168)(169)(170)(171)(172)(173)(174). Under heat stress, the liver can actively release various inflammatory mediators such as high-mobility group box-1 (HMGB1), which aggravates liver damage, suggesting that this factor may be a consequence of the inflammatory response that ensues during recovery rather than an acute response to heat stress (21,97,104,112,175).…”

Section: Tissue Injury Responsesmentioning

confidence: 99%

ZBP1 and heatstroke

Deng²,

He³

et al. 2023

Front. Immunol.

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Heatstroke, which is associated with circulatory failure and multiple organ dysfunction, is a heat stress-induced life-threatening condition characterized by a raised core body temperature and central nervous system dysfunction. As global warming continues to worsen, heatstroke is expected to become the leading cause of death globally. Despite the severity of this condition, the detailed mechanisms that underlie the pathogenesis of heatstroke still remain largely unknown. Z-DNA-binding protein 1 (ZBP1), also referred to as DNA-dependent activator of IFN-regulatory factors (DAI) and DLM-1, was initially identified as a tumor-associated and interferon (IFN)-inducible protein, but has recently been reported to be a Z-nucleic acid sensor that regulates cell death and inflammation; however, its biological function is not yet fully understood. In the present study, a brief review of the main regulators is presented, in which the Z-nucleic acid sensor ZBP1 was identified to be a significant factor in regulating the pathological characteristics of heatstroke through ZBP1-dependent signaling. Thus, the lethal mechanism of heatstroke is revealed, in addition to a second function of ZBP1 other than as a nucleic acid sensor.

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Section: Tissue Injury Responsesmentioning

confidence: 99%

ZBP1 and heatstroke

Deng²,

He³

et al. 2023

Front. Immunol.

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“…In addition, as you may derive from Tables 1 and 2, there seems to be a male predominance and an age range from 25–44 years of age [ 3 ], [ 4 ], [ 5 ], [ 6 ], [ 7 ], [ 8 ], [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Fatal heat stroke based on foudroyant irreversible multiple organ dysfunction in German summer

Lorenz,

Herold,

Lodes

et al. 2023

Innovative Surgical Sciences

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Objectives Heat stroke is a serious condition that might lead from moderate organ impairment to multiple organ dysfunction syndrome. Appropriate diagnosis-finding, fast initiation of cooling and intensive care are key measures of the initial treatment. Scientific case report based on i) clinical experiences obtained in the clinical management of a particularly rare case and ii) selected references from the medical scientific literature. Case presentation We present a case of a young and healthy construction worker who suffered from an exertional heat stroke with a body core temperature exceeding 42 °C by previous several hour work at 35 °C ambient temperature. Heat stroke was associated with foudroyant, not reversible multiple organ dysfunction syndrome, in particular, early disturbed coagulation, microcirculatory, liver and respiratory failure, and subsequent fatal outcome despite immediate diagnosis-finding, rapid external cooling and expanded intensive care management. Conclusions Basic knowledge on an adequate diagnosis(-finding in time) and treatment of heat stroke is important for (almost each) physician in the summertime as well as is essential for the initiation of an appropriate management. Associated high morbidity and mortality rates indicate the need for implementation of standard operation protocols.

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