Published online Jun 26, 2019. doi: 10.12998/wjcc.v7.i12.1467
Peer-review started: March 4, 2019
First decision: April 18, 2019
Revised: April 29, 2019
Accepted: May 1, 2019
Article in press: May 2, 2019
Published online: June 26, 2019
The growing popularity of marathon and half-marathon runs has led to an increased number of patients presenting with exertion-induced heat stroke. Mild hepatic involvement is often observed in these patients; however, fulminant liver failure may occur in approximately 5% of all cases. Liver transplantation is a potentially curative approach for exertion-induced liver failure, although there is a lack of consensus regarding the criteria and optimal timing of this intervention.
This paper describes 5 patients (4 men and 1 woman) who were referred to the department where this study was performed with the diagnosis of exertion-induced acute liver failure. Three patients underwent liver transplantation, 1 recovered spontaneously, and 1 patient died on day 11 following the exertion.
Exertion-induced heat stroke may present as fulminant liver failure. These patients may recover with conservative treatment, may require liver transplantation, or may die. No definitive criteria are available to determine patient suitability for a conservative vs surgical approach.
Core tip: Patients with exertion-induced heat stroke may develop fulminant liver failure and may recover with conservative treatment alone or require liver transplantation. To date, there is a lack of definitive criteria to identify patients who could potentially benefit from a surgical vs. a conservative approach. This study discusses a series of 5 cases in which the following 3 distinct clinical outcomes were observed in patients: spontaneous recovery, the need for liver transplantation, and death following exertion-induced liver failure.