Multy-system complications of accidental hypothermia: A case report

Introduction. Accidental hypothermia is an unintentional fall in core temperature to less than 35°C and it occurs when the body’s heat loss exceeds its heat production. The elderly population is particularly susceptible due to reduced adaptability to low temperatures and various comorbidities, which may be predisposing factors. Case Report. A 65-year-old Caucasian female was admitted to the hospital due to hypothermia (< 34°C), severe hypoglycemia (0.7 mmol/L), metabolic acidosis (6.970), elevated urea (42.4 mmol/L) and creatinine (686 μmol/L). The initial examination revealed shivering, dysarthria and general exhaustion. Hyperamylasemia (241 U/L) and hyperlipasemia (1920 U/L) were found on the second day after admission. Contrast enhanced computed tomography showed a focal asymmetric enlargement of the pancreatic head and body. Furthermore, a splenic infarction was also noticed. The complexity of human thermoregulatory mechanisms indicates the importance of precipitating factors in the development of hypothermia. Our patient presented with several precipitating factors such as age, sex, urinary tract infection, diabetes, and metformin-induced severe hypoglycemia. Conclusion. Based on the presented case and the relevant literature, it can be concluded that the clinical picture of hypothermia may be extremely complex. Knowledge of all the mechanisms involved in multi-organ failure due to hypothermia is of utmost importance, in order to conduct adequate and timely targeted diagnosis and apply appropriate treatment.