Diagnostic value of coagulation factor and intracranial pressure monitoring in acute liver failure from heat stroke: Case report and review of the literature

Background Exertional heat stroke (HS) with resultant acute liver failure (ALF) is a rare condition with high mortality. Diagnosis of ALF in the context of HS is confounded by numerous laboratory abnormalities related to multisystem organ dysfunction. Case Report We present the case of a 20-year-old male athlete with exertional HS who developed ALF and was treated successfully with orthotopic liver transplantation. He remained well after 1 year with normal liver function and no permanent neurologic impairment. Diagnosis and treatment was guided by serial monitoring of coagulation factors and intracranial pressure (ICP). Conclusions Currently, there are no well validated prognostic tools that predict the need for or survival with orthotopic liver transplantation for HS. We propose that serial monitoring of coagulation factors and, when safe and feasible, ICP monitoring may help to guide clinical decision making in this context.