Heat stroke laboratory findings: Difference between revisions

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==Overview==
==Overview==
The laboratory finding scene in patients with a heat stroke include [[hypophosphatemia]], [[hypokalemia]], [[hypoglycemia], tension of arterial carbon dioxide is usually less than 20 mm Hg. Respiratory alkalosis is seen in non-exertional heat stroke where as lactic acidosis and respiratory alkalosis in exertional heat stroke.
The laboratory finding scene in patients with a heat stroke include [[hypophosphatemia]], [[hypokalemia]], [[hypoglycemia]], tension of arterial carbon dioxide is usually less than 20 mm Hg. [[Respiratory alkalosis]] is seen in non-exertional heat stroke where as [[lactic acidosis]] and [[respiratory alkalosis]] in exertional heat stroke.<ref name="pmid6893120">{{cite journal| author=Kim RC, Collins GH, Cho C, Ichikawa K, Givelber H| title=Heat stroke. Report of three fatal cases with emphasis on findings in skeletal muscle. | journal=Arch Pathol Lab Med | year= 1980 | volume= 104 | issue= 7 | pages= 345-9 | pmid=6893120 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6893120  }} </ref>
 


==Laboratory Findings==
==Laboratory Findings==
The following laboratory findings may be noticed in a patient with heat stroke:<ref name="pmid25880507">{{cite journal| author=Leon LR, Bouchama A| title=Heat stroke. | journal=Compr Physiol | year= 2015 | volume= 5 | issue= 2 | pages= 611-47 | pmid=25880507 | doi=10.1002/cphy.c140017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25880507  }} </ref>
The following laboratory findings may be noticed in a patient with heat stroke:<ref name="pmid6893120">{{cite journal| author=Kim RC, Collins GH, Cho C, Ichikawa K, Givelber H| title=Heat stroke. Report of three fatal cases with emphasis on findings in skeletal muscle. | journal=Arch Pathol Lab Med | year= 1980 | volume= 104 | issue= 7 | pages= 345-9 | pmid=6893120 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6893120  }} </ref><ref name="pmid25880507">{{cite journal| author=Leon LR, Bouchama A| title=Heat stroke. | journal=Compr Physiol | year= 2015 | volume= 5 | issue= 2 | pages= 611-47 | pmid=25880507 | doi=10.1002/cphy.c140017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25880507  }} </ref><ref name="pmid7663007">{{cite journal| author=Macario AJ| title=Heat-shock proteins and molecular chaperones: implications for pathogenesis, diagnostics, and therapeutics. | journal=Int J Clin Lab Res | year= 1995 | volume= 25 | issue= 2 | pages= 59-70 | pmid=7663007 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7663007  }} </ref>
{| align=center
|-
|
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Characteristic
!align="center" style="background:#4479BA; color: #FFFFFF;" |Exertional Heat Stroke
!align="center" style="background:#4479BA; color: #FFFFFF;" |Classic Heat Stroke
|-
| rowspan="7" align="center" style="background:#DCDCDC;"|Laboratory findings
|align="center" style="background:#DCDCDC;"|Acid-base disturbance
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Metabolic acidosis]]
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Mixed [[Metabolic Acidosis|metabolic]] and [[respiratory acidosis]]
|-
|align="center" style="background:#DCDCDC;"|[[Calcium]]
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
|-
|align="center" style="background:#DCDCDC;"|[[Potassium]]
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓ or ↑
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
|-
|align="center" style="background:#DCDCDC;"|[[Phosphate]]
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
|-
|align="center" style="background:#DCDCDC;"|[[Blood glucose]]
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
|-
|align="center" style="background:#DCDCDC;"|[[Creatine kinase]] (CK)
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑↑↑
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
|-
|align="center" style="background:#DCDCDC;"|[[Aspartate transaminase|AST]], [[Alanine transaminase|ALT]]
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑↑↑
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
|-
|}
|}
*The tension of arterial carbon dioxide is usually less than 20 mm Hg
*The tension of arterial carbon dioxide is usually less than 20 mm Hg
*Respiratory alkalosis in non-exertional heat stroke
*[[Respiratory alkalosis]] in non-exertional heat stroke
*Lactic acidosis and respiratory alkalosis in exertional heat stroke
*[[Lactic acidosis]] and [[respiratory alkalosis]] in exertional heat stroke
 
*[[Hypophosphatemia]]
*[[Hypophosphatemia]]
*[[Hypokalemia]]
*[[Hypokalemia]]
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**[[Hypercalcemia]]
**[[Hypercalcemia]]
**[[Hyperproteinemia]]
**[[Hyperproteinemia]]
*Elevated creatinine kinase
*Elevated [[AST]] and [[ALT]]


===Laboratory Findings after Cooling in Exertional Heat Stroke===
===Laboratory Findings after Cooling in Exertional Heat Stroke===
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*[[Hypocalcemia]]
*[[Hypocalcemia]]
*[[Hyperkalemia]]
*[[Hyperkalemia]]
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 19:35, 30 May 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Overview

The laboratory finding scene in patients with a heat stroke include hypophosphatemia, hypokalemia, hypoglycemia, tension of arterial carbon dioxide is usually less than 20 mm Hg. Respiratory alkalosis is seen in non-exertional heat stroke where as lactic acidosis and respiratory alkalosis in exertional heat stroke.[1]

Laboratory Findings

The following laboratory findings may be noticed in a patient with heat stroke:[1][2][3]

Characteristic Exertional Heat Stroke Classic Heat Stroke
Laboratory findings Acid-base disturbance Metabolic acidosis Mixed metabolic and respiratory acidosis
Calcium Nl
Potassium ↓ or ↑ Nl
Phosphate
Blood glucose
Creatine kinase (CK) ↑↑↑
AST, ALT ↑↑↑

Laboratory Findings after Cooling in Exertional Heat Stroke

References

  1. 1.0 1.1 Kim RC, Collins GH, Cho C, Ichikawa K, Givelber H (1980). "Heat stroke. Report of three fatal cases with emphasis on findings in skeletal muscle". Arch Pathol Lab Med. 104 (7): 345–9. PMID 6893120.
  2. Leon LR, Bouchama A (2015). "Heat stroke". Compr Physiol. 5 (2): 611–47. doi:10.1002/cphy.c140017. PMID 25880507.
  3. Macario AJ (1995). "Heat-shock proteins and molecular chaperones: implications for pathogenesis, diagnostics, and therapeutics". Int J Clin Lab Res. 25 (2): 59–70. PMID 7663007.

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