Heatstroke syndrome is a well-described state, which usually occurs in areas with warm climates. Two forms are
commonly distinguished: the exertional and the classic heatstroke. Increased serum levels of liver enzymes are often
detected in this condition. However, acute hepatic failure following exertional heatstroke is rare. We report a case
of a 30 years old man with exertional heatstroke, acute hepatic failure, serious coagulation impairment and
a rhabdomyolysis following ten kilometres run. Acute hepatic failure completely developed the forth day of
hospitalisation. On the fifth day, the patient fulfilled London criteria for liver transplantation and was referred to the
transplantation center for the optimal management assessment. After the conservative management of acute phase,
spontaneous recovery of liver functions occurred and the patient finally was not transplanted. 23 days after admission
to the hospital, the patient was discharged with residual cholestasis and was followed up on outpatient basis. Serum
levels of liver enzyme returned to the normal 3 months after the liver injury. In several cases, the liver failure following
heatstroke is reversible and conservativemanagement can be successful. Additionally, in 3 reported cases, emergency
liver transplantation for acute hepatic failure due to heatstroke with renal failure and coma showed very poor outcome.
Our case demonstrates that conservative management even in patients fulfilling accepted criteria for emergency liver
transplantation can be effective and should be considered in similar condition.
acute liver failure, heatstroke, disseminated intravascular coagulopathy, rhabdomyolysis, liver