Multiple organ failure following severe heat stroke complicated by AMSAN-type Guillain-Barré syndrome: a case report and literature review

Heat stroke is a severe form of heat-related injury that can provoke a systemic inflammatory response and cytokine storm, disrupting immune homeostasis. Guillain–Barré syndrome (GBS) has rarely been reported during recovery from heat stroke, and the nature of this association remains uncertain. This report describes a patient who developed GBS during recovery from severe heat stroke. A previously healthy 57-year-old man presented with confusion and hyperthermia while hiking and subsequently developed multiple organ failure. He was initially treated for heat stroke. After regaining consciousness, he developed reduced muscle tone and sensory disturbances in all four limbs and was diagnosed with acute motor-sensory axonal neuropathy (AMSAN), a GBS subtype. His neurological function gradually improved after plasma exchange, intravenous immunoglobulin, and rehabilitation. We also compare this case with published reports of GBS temporally associated with heat stroke. Heat stroke may have acted as a potential atypical immune trigger for GBS in this patient. This possibility may be related to severe systemic inflammation and immune dysregulation induced by heat stroke. Clinicians should maintain a high level of suspicion for GBS in patients who develop progressive neurological deficits during the recovery phase of heat stroke. Timely neurophysiological and cerebrospinal fluid assessments are crucial for early diagnosis and intervention, which may improve patient outcomes.