Pediatric Nephrology

, Volume 28, Issue 6, pp 971–974

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 Zilleruelo
  • Carolyn L. Abitbol
Brief Report

Abstract

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.

Keywords

Therapeutic plasma exchange Heat stroke Continuous renal replacement therapy 

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Copyright information

© IPNA 2013

Authors and Affiliations

  • Vimal Master Sankar Raj
    • 1
    • 2
  • Amanda Alladin
    • 2
  • Brent Pfeiffer
    • 3
  • Chryso Katsoufis
    • 1
  • Marissa Defreitas
    • 1
    • 2
  • Alicia Edwards-Richards
    • 1
    • 2
  • Jayanthi Chandar
    • 1
  • Wacharee Seeherunvong
    • 1
  • Gwenn McLaughlin
    • 3
  • Gaston Zilleruelo
    • 1
  • Carolyn L. Abitbol
    • 1
  1. 1.Department of Pediatrics, Division of Pediatric Nephrology (R-714)University of Miami/Holtz Children’s Hospital at Jackson Health SystemMiamiUSA
  2. 2.Pediatric Postgraduate Training ProgramUniversity of Miami/Holtz Children’s Hospital at Jackson Health SystemMiamiUSA
  3. 3.Pediatric Critical Care MedicineUniversity of Miami/Holtz Children’s Hospital at Jackson Health SystemMiamiUSA

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