Heat Stroke and Pregnancy.
Zackary Bailey, David Evans, Collin Hu et al.
✦ AI-curated · Sources linked
Case in brief
A 33-year-old woman developed heat stroke during a high-intensity event and was incidentally found to be pregnant. AST and ALT rose to 8k and CK peaked at 36k, raising concern for acute liver failure and prompting discussion of possible transplantation, which was not required. Pregnancy viability could not be determined during admission. After discharge, light activity was associated with quadriceps soreness, CK peaking at 5k, and AST/ALT rising to 234/1062 about a month after admission. With continued rest, symptoms resolved and CK and liver enzymes normalized; the pregnancy was proceeding normally.
What made this case unusual
Marked muscle and liver enzyme elevations recurred with light activity after discharge, including after moderate walking, in a pregnant patient recovering from heat stroke.
Diagnostic / clinical pearl
Heat stroke can involve substantial muscle injury and liver enzyme elevation, with abnormalities recurring during recovery after relatively light exertion; follow-up should account for this possibility.
Why it matters
The authors considered her at high risk for dehydration, shock liver, and repeat heat injury during her first delivery, and noted that she met criteria for heat tolerance testing.