Abstract

IntroductionLittle information is available on the pathogenesis of heatstroke without strenuous exercise in younger patients. Here, we report the case of a 31-year-old man who developed heatstroke secondary to hyponatremia. His condition was initially misdiagnosed as classic heatstroke. We hope the detailed description of our patient’s case will provide valuable information for medical professionals faced with similar cases in the future.Case presentationA 31-year-old Japanese man who was regularly taking anti-hypertensive agents, including a thiazide, was admitted to our hospital owing to consciousness disturbance and a high-grade fever. A thorough examination revealed mild renal dysfunction, rhabdomyolysis, a hyper-coagulable state, and severe hyponatremia (114mEq/L). Because he worked in a hot environment, an initial diagnosis of heatstroke was established. His general condition improved rapidly with supportive measures, and he was discharged on the fourth day after admission. Interestingly, he did not recognize feeling hot while working in a hot environment. These findings suggest that the consciousness disturbance, which was probably attributable to acute hyponatremia caused by the thiazide, preceded the onset of the heatstroke.ConclusionsClinicians should consider the presence of underlying diseases, especially consciousness disturbance, when younger individuals develop heatstroke in the absence of strenuous exercise.

Highlights

  • Little information is available on the pathogenesis of heatstroke without strenuous exercise in younger patients

  • His general condition improved rapidly with supportive measures, and he was discharged on the fourth day after admission. He did not recognize feeling hot while working in a hot environment. These findings suggest that the consciousness disturbance, which was probably attributable to acute hyponatremia caused by the thiazide, preceded the onset of the heatstroke

  • Clinicians should consider the presence of underlying diseases, especially consciousness disturbance, when younger individuals develop heatstroke in the absence of strenuous exercise

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Summary

Introduction

Little information is available on the pathogenesis of heatstroke without strenuous exercise in younger patients. Because he worked in a hot environment, an initial diagnosis of heatstroke was established. These findings suggest that the consciousness disturbance, which was probably attributable to acute hyponatremia caused by the thiazide, preceded the onset of the heatstroke. Conclusions: Clinicians should consider the presence of underlying diseases, especially consciousness disturbance, when younger individuals develop heatstroke in the absence of strenuous exercise. * Correspondence: masaki108@gmail.com 1Tokyo Metropolitan Bokutoh General Hospital, 4-23-15, Kohtohbashi, Sumida-ku, Tokyo, Japan Full list of author information is available at the end of the article whose condition was diagnosed as heatstroke attributed to doing light work in a hotel room.

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