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Jiang D, Zhao M, Li X, Hu Q, Zhang Q. Case report and literature review: Acute rhabdomyolysis caused by overheating of electric blanket complicated with Guillain-Barré syndrome. Front Neurol 2024; 15:1362648. [PMID: 38450069 PMCID: PMC10915280 DOI: 10.3389/fneur.2024.1362648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/09/2024] [Indexed: 03/08/2024] Open
Abstract
Rhabdomyolysis (RM) induced by electric blankets is exceedingly rare, with only three cases identified in our literature review. Both RM and Guillain-Barré syndrome (GBS) present with similar clinical manifestations of myalgia and muscle weakness, posing a potential challenge for accurate diagnosis in clinical settings. This report presents the case of a 22-year-old man who developed RM subsequent to the use of an electric blanket. Despite undergoing plasma exchange and renal replacement therapy, the patient continued to exhibit poor muscle strength in both lower limbs. Subsequent comprehensive evaluation revealed the presence of concurrent GBS. Following a 5-day course of intravenous gamma globulin treatment, the patient experienced rapid recovery of muscle strength and was discharged. Additionally, we reviewed seven cases from the literature of coexistent RM and GBS. This indicated that investigation of the timing of onset of muscle strength decline in RM patients could help to identify potential concurrent neurological or muscular disorders. In cases in which concurrent GBS and RM cannot be definitively ascertained during early hospitalization, prioritizing plasma exchange treatment may lead to improved patient outcomes.
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Affiliation(s)
- Dongyang Jiang
- Department of Nephrology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
| | - Ming Zhao
- Department of Nephrology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
| | - Xiaojun Li
- Department of Nephrology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
| | - Qiongdan Hu
- Department of Nephrology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
- Institute of Integrated Chinese and Western Medicine, Southwest Medical University, Luzhou, Sichuan, China
| | - Qiong Zhang
- Department of Nephrology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
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Iba T, Helms J, Levi M, Levy JH. The role of platelets in heat-related illness and heat-induced coagulopathy. Thromb Res 2023; 231:152-158. [PMID: 35989192 DOI: 10.1016/j.thromres.2022.08.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/22/2022] [Accepted: 08/09/2022] [Indexed: 12/31/2022]
Abstract
Heat-related illness is becoming more problematic due to ongoing global warming. Heat-related injury causes systemic inflammation and coagulopathy, due to leukocyte, platelet, and vascular endothelial cell activation and injury. Hyperthermia directly modulates platelet function and can induce cellular damage. Meanwhile, heat also affects platelet function via activated coagulation, excess inflammation, production of cytokines, and heat shock proteins. Aberrant hyperthermia-induced interactions between leukocytes and endothelial cells are also involved in platelet regulation. Heat-induced coagulopathy commonly progresses to disseminated intravascular coagulation (DIC), leading to multiple organ failure and in some cases enhanced bleeding. Consequently, platelet count, prothrombin time, and DIC score are useful for evaluating the severity of heat-related illness in addition to other organ damage markers such as Glasgow Coma Scale, creatinine, and bilirubin. Despite the increasing risk, therapeutic modalities targeting platelets are limited and no established therapy exists. In this review, we summarize the current knowledge about the role of platelets in the pathogenesis, diagnosis, and management of heat-related illness.
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Affiliation(s)
- Toshiaki Iba
- Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Julie Helms
- Strasbourg University (UNISTRA), Strasbourg, France; Strasbourg University Hospital, Medical Intensive Care Unit - NHC, Strasbourg, France; INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France
| | - Marcel Levi
- Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Department of Medicine, University College London Hospitals NHS Foundation Trust, and Cardio-metabolic Programme-NIHR UCLH/UCL BRC, London, UK
| | - Jerrold H Levy
- Department of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, NC, USA
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Bushong LC, Diao Z. Fatal pediatric hyperthermia: A forensic review. J Forensic Sci 2022; 67:1092-1107. [PMID: 35103301 DOI: 10.1111/1556-4029.14989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/01/2021] [Accepted: 01/06/2022] [Indexed: 11/27/2022]
Abstract
This paper examines a pediatric hyperthermia homicide in which the decedent was placed into a room with only a diaper on and left unattended overnight. There were no furnishings in the room except for a 1500-W space heater and a stroller. The following morning, emergency personnel were summoned to the residence. A caretaker said the decedent playing normally 5 min before making the 911 call. The decedent's initial rectal temperature was 42.2°C. Law enforcement asked how long the child had to be exposed to a high temperature in order to induce fatal hyperthermia in an empty bedroom. The scene was reconstructed using the child's residence and the same heater. Environmental data were gathered over a 16-h period. The thermal parameters of the room and environment were analyzed using a lumped-element thermal model. These parameters were then fed into an adapted Gagge's two-node model of human thermal regulation, which provided a time-window of exposure necessary to elicit hyperthermia, which in this case, depending on certain variables, ranged from 45 min to 4 h.
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Affiliation(s)
- Lee C Bushong
- Department of Sociology and Criminal Justice, Florida Agricultural and Mechanical University (FAMU), Tallahassee, Florida, USA
| | - Zhu Diao
- Department of Electronic Engineering, Maynooth University, Maynooth, Ireland.,Maynooth International Engineering College, Maynooth University, Maynooth, Ireland
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Wang Z, Tuo Y, Li B, Deng K, Han S, Luo Y, Sun Q, Li Z, Chen Y, Wang Z, Huang P. Preliminary study on fatal hyperthermia in rat liver tissue by Fourier transform infrared microspectroscopy. AUST J FORENSIC SCI 2017. [DOI: 10.1080/00450618.2016.1156157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Zhijun Wang
- Department of Forensic Pathology, Institute of Forensic Science, Ministry of Justice, Shanghai, China
- Department of Forensic Pathology, School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Ya Tuo
- Department of Biochemistry and Physiology, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Bing Li
- Department of Forensic Pathology, School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Kaifei Deng
- Department of Forensic Pathology, Institute of Forensic Science, Ministry of Justice, Shanghai, China
| | - Shunqi Han
- Department of Forensic Pathology, Institute of Forensic Science, Ministry of Justice, Shanghai, China
| | - Yiwen Luo
- Department of Forensic Pathology, Institute of Forensic Science, Ministry of Justice, Shanghai, China
| | - Qiran Sun
- Department of Forensic Pathology, Institute of Forensic Science, Ministry of Justice, Shanghai, China
| | - Zhengdong Li
- Department of Forensic Pathology, Institute of Forensic Science, Ministry of Justice, Shanghai, China
| | - Yijiu Chen
- Department of Forensic Pathology, Institute of Forensic Science, Ministry of Justice, Shanghai, China
| | - Zhenyuan Wang
- Department of Forensic Pathology, School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Ping Huang
- Department of Forensic Pathology, Institute of Forensic Science, Ministry of Justice, Shanghai, China
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Alunni V, Crenesse D, Pierccechi-Marti MD, Gaillard Y, Quatrehomme G. Fatal heat stroke in a child entrapped in a confined space. J Forensic Leg Med 2015; 34:139-44. [DOI: 10.1016/j.jflm.2015.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 05/19/2015] [Accepted: 05/26/2015] [Indexed: 11/17/2022]
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Herbst J, Mason K, Byard RW, Gilbert JD, Charlwood C, Heath KJ, Winskog C, Langlois NE. Heat-related deaths in Adelaide, South Australia: Review of the literature and case findings – An Australian perspective. J Forensic Leg Med 2014; 22:73-8. [DOI: 10.1016/j.jflm.2013.12.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 10/31/2013] [Accepted: 12/07/2013] [Indexed: 11/30/2022]
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Wang Q, Ishikawa T, Michiue T, Zhu BL, Guan DW, Maeda H. Molecular pathology of pulmonary edema in forensic autopsy cases with special regard to fatal hyperthermia and hypothermia. Forensic Sci Int 2013; 228:137-41. [DOI: 10.1016/j.forsciint.2013.03.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 08/07/2012] [Accepted: 03/04/2013] [Indexed: 10/27/2022]
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Palmiere C, Mangin P. Hyperthermia and postmortem biochemical investigations. Int J Legal Med 2012; 127:93-102. [DOI: 10.1007/s00414-012-0722-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 05/24/2012] [Indexed: 12/22/2022]
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Wang Q, Ishikawa T, Michiue T, Zhu BL, Guan DW, Maeda H. Evaluation of human brain damage in fatalities due to extreme environmental temperature by quantification of basic fibroblast growth factor (bFGF), glial fibrillary acidic protein (GFAP), S100β and single-stranded DNA (ssDNA) immunoreactivities. Forensic Sci Int 2012; 219:259-64. [DOI: 10.1016/j.forsciint.2012.01.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 11/14/2011] [Accepted: 01/04/2012] [Indexed: 11/28/2022]
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