2018 Volume 51 Issue 9 Pages 539-544
A 38-year-old male suffered exertional heat stroke after running 10 km on a sunny day in April and became comatose. He was sent to hospital by ambulance. He received supportive treatment, such as cooling and intravenous infusions. During the first 24 hours, although his consciousness status and general condition improved, his serum aspartate aminotransferase (AST) and creatine phosphokinase (CPK) levels increased markedly. His liver function deteriorated steadily after he was transferred to our hospital. He exhibited AST, alanine aminotransferase (ALT), and creatinine levels of 11,730 U/L, 6,509 U/L, and 0.87 mg/dL, respectively; a platelet count of 4.7×104/μL; and a prothrombin level of 17%. We performed plasma exchange (PE) and continuous hemodiafiltration (CHDF) for disseminated intravascular coagulation and acute liver failure. The patient’s AST and ALT levels gradually decreased. He was discharged from our hospital 18 days after his admission. Severe liver failure due to exertional heat stroke typically occurs at 3 days after onset. We experienced a case of acute liver failure induced by heat stroke, which was successfully treated with PE and CHDF.