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We report the case of a young patient who presented two self-limited episodes of acute jaundice that developed immediately following a long distance run. Zone 3 necrosis was the most prominent histologic change of the liver during the second episode. The diagnosis of heatstroke with liver damage was based on the exclusion of known causes of acute hepatitis, the histopathologic changes and the circumstances preceding the onset of liver disease. This seems to be the first case of severe and recurrent liver impairment due to heatstroke.
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