TY - JOUR
T1 - Therapeutic plasma exchange in the treatment of exertional heat stroke and multiorgan failure
AU - Raj, Vimal Master Sankar
AU - Alladin, Amanda
AU - Pfeiffer, Brent
AU - Katsoufis, Chryso
AU - Defreitas, Marissa
AU - Edwards-Richards, Alicia
AU - Chandar, Jayanthi
AU - Seeherunvong, Wacharee
AU - McLaughlin, Gwenn
AU - Zilleruelo, Gaston E
AU - Abitbol, Carolyn L.
PY - 2013/6/1
Y1 - 2013/6/1
N2 - 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.
AB - 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.
KW - Continuous renal replacement therapy
KW - Heat stroke
KW - Therapeutic plasma exchange
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U2 - 10.1007/s00467-013-2409-8
DO - 10.1007/s00467-013-2409-8
M3 - Article
C2 - 23338054
AN - SCOPUS:84880570306
VL - 28
SP - 971
EP - 974
JO - Pediatric Nephrology
JF - Pediatric Nephrology
SN - 0931-041X
IS - 6
ER -