Sunstroke with severe liver dysfunction: A case report

We report a case with sunstroke and severe liver damage. A 17-year-old male student was admitted to our hospital because of jaundice on Aug. 1982. His family history and past history were noncontributory. He suddenly lost his consciousness while playing soccer under burning sun on Aug. 23. On admiss...

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Published inKanzo Vol. 26; no. 4; pp. 506 - 509
Main Authors ABE, Takashi, ITO, Masataka, UEHARA, Hidemasa, TAKAHASHI, Shinichi, SAITO, Shozo, AOYAGI, Toshio, TAMAKI, Kazuhiro, UTUNOMIYA, Kiyoshi
Format Journal Article
LanguageJapanese
Published The Japan Society of Hepatology 1985
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ISSN0451-4203
1881-3593
DOI10.2957/kanzo.26.506

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Abstract We report a case with sunstroke and severe liver damage. A 17-year-old male student was admitted to our hospital because of jaundice on Aug. 1982. His family history and past history were noncontributory. He suddenly lost his consciousness while playing soccer under burning sun on Aug. 23. On admission to another hospital he was soporous with body temperature of 40°C. On Aug. 25, deterioration of liver function was detected and he was transfered to our hospital, while his consciousness became clear. On admission he was icteric and liver was palpable 2 fingerbreadth under the right costal arch. Laboratory data on admission were as follows, GOT 4, 224, GPT 5, 190, CPK 4, 920, LDH 7, 050, total bilirubin 4.5mg/dl and prothrombin time 30%. Urinary myoglobin was positive HBV markers and HA antibody were negative. After admission the patient improved progressively and liver function tests were normalized. Liver biopsy performed 3 weeks after admission revealed preserved lobular archtecture with scattered binuclear cells. Inflammatory cell infiltration was scarcely seen. The mechanism of liver cell dysfunction in patients with sunstroke is not clarified yet, although effects of high body temperature, disturbed hepatic circulation and hypoxia are presumed.
AbstractList We report a case with sunstroke and severe liver damage. A 17-year-old male student was admitted to our hospital because of jaundice on Aug. 1982. His family history and past history were noncontributory. He suddenly lost his consciousness while playing soccer under burning sun on Aug. 23. On admission to another hospital he was soporous with body temperature of 40°C. On Aug. 25, deterioration of liver function was detected and he was transfered to our hospital, while his consciousness became clear. On admission he was icteric and liver was palpable 2 fingerbreadth under the right costal arch. Laboratory data on admission were as follows, GOT 4, 224, GPT 5, 190, CPK 4, 920, LDH 7, 050, total bilirubin 4.5mg/dl and prothrombin time 30%. Urinary myoglobin was positive HBV markers and HA antibody were negative. After admission the patient improved progressively and liver function tests were normalized. Liver biopsy performed 3 weeks after admission revealed preserved lobular archtecture with scattered binuclear cells. Inflammatory cell infiltration was scarcely seen. The mechanism of liver cell dysfunction in patients with sunstroke is not clarified yet, although effects of high body temperature, disturbed hepatic circulation and hypoxia are presumed.
Author TAMAKI, Kazuhiro
TAKAHASHI, Shinichi
ABE, Takashi
ITO, Masataka
UEHARA, Hidemasa
UTUNOMIYA, Kiyoshi
SAITO, Shozo
AOYAGI, Toshio
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  fullname: TAMAKI, Kazuhiro
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  fullname: UTUNOMIYA, Kiyoshi
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References 1) Kew M, Bersohn I, Seftel H: Liver damage in heat stroke. Amer J Med 49: 192-202, 1970
8) Herman RH, Sullivan BH: Heat stroke and jaundice. Amer J Med 27: 154-166, 1959
3) Proulx BP: Heat stress disease. in principles and practice of emergency medicine: 815-822, 1978
4) 笹原経子,小沢武文,田村康二,他:各種血清酵素の上昇を示した日射病の1例.日内会誌68: 1126-1132, 1979
5) 杉本侃,吉岡敏治,橋本公昭:高温環境下の障害-いわゆる熱射病.綜合臨牀29: 555-558, 1980
2) 田岡賢雄:熱射病.臨床と研究56: 2506-2512, 1979
6) 稲垣王子,土居真,宮本孝,他:急性肝壊死を合併した運動後の横紋筋融解症の1例.日内会誌71: 47-52, 1981
7) 笠島眞,高瀬修二郎,金山隆一:肝障害を伴った熱射病の1例.内科45: 664-667, 1980
References_xml – reference: 4) 笹原経子,小沢武文,田村康二,他:各種血清酵素の上昇を示した日射病の1例.日内会誌68: 1126-1132, 1979
– reference: 2) 田岡賢雄:熱射病.臨床と研究56: 2506-2512, 1979
– reference: 7) 笠島眞,高瀬修二郎,金山隆一:肝障害を伴った熱射病の1例.内科45: 664-667, 1980
– reference: 5) 杉本侃,吉岡敏治,橋本公昭:高温環境下の障害-いわゆる熱射病.綜合臨牀29: 555-558, 1980
– reference: 1) Kew M, Bersohn I, Seftel H: Liver damage in heat stroke. Amer J Med 49: 192-202, 1970
– reference: 3) Proulx BP: Heat stress disease. in principles and practice of emergency medicine: 815-822, 1978
– reference: 6) 稲垣王子,土居真,宮本孝,他:急性肝壊死を合併した運動後の横紋筋融解症の1例.日内会誌71: 47-52, 1981
– reference: 8) Herman RH, Sullivan BH: Heat stroke and jaundice. Amer J Med 27: 154-166, 1959
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Snippet We report a case with sunstroke and severe liver damage. A 17-year-old male student was admitted to our hospital because of jaundice on Aug. 1982. His family...
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Title Sunstroke with severe liver dysfunction: A case report
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