A case of exertional heat stroke with multiple organ failure after long distance race

Exertional heat stroke developed in a 29-year-old man who ran a long distance race (10 kilometers) in cold weather. Multiple organ failure including acute renal failure, hepatic failure, pancreatitis and disseminated intravascular coagulation occurred on the fifth hospital day. Hemodialysis and plasmapheresis with the administration of nafamostat mesilate as well as AT-III resulted in improvement of multiple organ failure. The renal biopsy specimen obtained during the recovery stage revealed residual evidence of acute tubular necrosis. This case indicates the usefulness of hemodialysis and plasmapheresis as a treatment for multiple organ failure induced by exertion al heat stroke.