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July 1991

Hyperpyrexia, Hemorrhagic Shock and Encephalopathy, and Creatinine Phosphokinase

Author Affiliations

Department of Pediatrics Kaiser Los Angeles Medical Center 4867 Sunset Blvd Los Angeles, CA 90027

Am J Dis Child. 1991;145(7):718. doi:10.1001/archpedi.1991.02160070013004

Sir.—In his October 1990 editorial in AJDC, Corrigan1 recommends that the "H" in the syndrome of hemorrhagic shock and encephalopathy (HSE) stand for hyperpyrexia. This is a welcome suggestion to the clinician because it underscores hyperpyrexia as an important clue to the diagnosis of this new syndrome. In February 1985, we were at a loss to explain a difficult patient who showed clinical symptoms of heatstroke. The original description of HSE by Levin et al2 in 1983 did not view hyperpyrexia as a prominent feature of this disorder. Only two of the 10 patients described had temperatures of 41°C or greater. It was not until a subsequent report3 emphasized hyperpyrexia that we were alerted to the similarity between our case and those being described in the literature.

Patient Report.—A 3-year-old black girl was well until 11 pm on the evening of admission, when she vomited

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