THBD and Heat Stroke: The pathogenesis of heat stroke is characterized by a significant elevation in biomarkers of endothelial injury, particularly vWF, plasminogen activator inhibitor-1 and soluble thrombomodulin (TM), which are prominently increased in plasma during heat stroke (Bergonzelli and Kruithof, 1991; Shieh et al., 1995; Rücker et al., 2006; Kawasaki et al., 2014).