Physiological studies on heat exhaustion victims among Mecca pilgrims

This investigation focuses on the hormonal response to electrolyte changes and water loss in patients suffering from heat exhaustion, hospitalized in Muna during Hajj seasons. The concentrations of cortisol, aldosterone, renin (PRA), vasopressin (ADH) parathyroid hormone (PTH), adrenocorticotrophic hormone (ACTH) and growth hormone (GH) were determined in venous blood samples drawn from the patients upon admission, during, and after treatment. Highly elevated PRA mean values (396.77 +/- 88.58-462.18 +/- 106.95 ng.ml-1.h-1) were recorded, with no statistically significant difference between the readings. A similar trend was seen for cortisol (42.92 +/- 4.30-60.20 +/- 11.90 ug/dl). Vasopressin (ADH) showed a highly elevated value upon admission (42.48 +/- 18.82 pg/ml), which decreased to 23.66 +/- 8.27 pg/ml during treatment, and declined further to 7.67, ranging between 4.04 and 11.30 pg/ml, thereafter. Statistically speaking, however, there was no significant difference between these readings. PTH concentration, on the other hand, increased from an initial value of 143.31 +/- 47.64 to 245.90 +/- 107.34 pmol/l after treatment, but again there was no significant difference between the values. ACTH concentrations showed no detectable values throughout this study. The GH concentration was within normal throughout, ranging from 4.42 +/- 0.87 to 5.19 +/- 1.78 ng/ml. Aldosterone concentration was significantly reduced in the patients upon admission, with an initial value of 187.93 +/- 21.41 pg/ml (p < 0.05 as compared to normal mean value). During and after treatment, aldosterone values were still significantly lower than normal mean (152.63 +/- 13.47, p < 0.05; 145.2 +/- 17.55, p < 0.01, respectively), thereby shedding some light on the possible etiology of persistent metabolic acidosis.(ABSTRACT TRUNCATED AT 250 WORDS)