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- Title
Therapeutic plasma exchange in the treatment of exertional heat stroke and multiorgan failure.
- Authors
Raj, Vimal; Alladin, Amanda; Pfeiffer, Brent; Katsoufis, Chryso; Defreitas, Marissa; Edwards-Richards, Alicia; Chandar, Jayanthi; Seeherunvong, Wacharee; McLaughlin, Gwenn; Zilleruelo, Gaston; Abitbol, Carolyn
- Abstract
Background: Exertional heat stroke (EHS) results in a constellation of systemic inflammatory responses resulting in multiorgan failure and an extremely high mortality. Case Diagnosis and Treatments: 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.
- Subjects
HEAT stroke; MULTIPLE organ failure; BLOOD filtration; CHOLESTASIS; DYSPNEA; KIDNEY diseases; LIVER diseases; PLASMA exchange (Therapeutics); MUSCLE cramps; THERAPEUTICS
- Publication
Pediatric Nephrology, 2013, Vol 28, Issue 6, p971
- ISSN
0931-041X
- Publication type
Report
- DOI
10.1007/s00467-013-2409-8