Therapeutic plasma exchange in the treatment of exertional heat stroke and multiorgan failure

Vimal Master Sankar Raj, Amanda Alladin, Brent Pfeiffer, Chryso Katsoufis, Marissa Defreitas, Alicia Edwards-Richards, Jayanthi Chandar, Wacharee Seeherunvong, Gwenn McLaughlin, Gaston E Zilleruelo, Carolyn L. Abitbol

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)971-974
Number of pages4
JournalPediatric Nephrology
Issue number6
StatePublished - Jun 1 2013


  • Continuous renal replacement therapy
  • Heat stroke
  • Therapeutic plasma exchange

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health


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