Liver damage in heatstroke

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The effects of heatstroke on the structure and function of the liver have been studied in thirty-nine Bantu gold miners. Hepatocellular damage was found to be invariable. In a minority of patients (about 10 per cent) the liver damage was severe and may have contributed to a fatal outcome. In the remainder it was mild or moderate and could be detected only on biochemical testing or liver biopsy. The pathologic changes consisted of centrolobular degeneration or necrosis of hepatocytes and congestion; cholestasis and portal venular dilatation were prominent in the fatal cases. In the patients who survived, the histologic and biochemical abnormalities were completely reversible. It is suggested that the hepatic changes are the result of a combination of hypoxia and direct thermal injury.

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    From the Department of Medicine, University of the Witwatersrand and Johannesburg General Hospital, Johannesburg, the South African Institute for Medical Research, Johannesburg, and the Department of Pathology, Northwestern University and Wesley Memorial Hospital, Chicago, Illinois. This study was supported by a grant from the South African Chambers of Mines.

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