exertional heat stroke and doping: what about soldiers? a case report of amphetamine use

Introduction: exertional heat stroke is a pathology well known to military doctors because it is not uncommon for our soldiers to regularly make intense efforts in difficult training or operational missions. idiopathic etiology and genetics are by far the most described. we report for the first time a case of exertional heat stroke secondary to amphetamine use in the military environment and here, let’s raise the issue of ethics in the army. case presentation: a young parachutist soldier presented an episode of general convulsions complicating an exertional heat stroke during an 8 km race in battledress and combat boots. after further investigations, laboratory results found amphetamine in the urine. even if the soldier only allowed branched chain amino acids (bcaas) supplements, this exertional heat stroke was due to amphetamine use. after a review of the physiopathological effects of amphetamine, we will recall the various means of screening with their limits. many of our soldiers consume dietary supplements to be able to better endure the constraints to which they are exposed in internship or operations. conclusions: doping, willingly or not, is a reality in our army, even though we still struggle to understand it. health and command chains must be vigilant to these lines to preserve the health of our military on the one hand and enforce a code of ethics on the other.