This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Capacchione, J. F. Articles by Muldoon, S. M. Search for Related Content PubMed PubMed Citation Articles by Capacchione, J. F. Articles by Muldoon, S. M. Related Collections Mechanisms Complications Patient Safety Genetics Pharmacology

---

PATIENT SAFETY

Trauma, Systemic Inflammatory Response Syndrome, Dietary Supplements, Illicit Steroid Use and a Questionable Malignant Hyperthermia Reaction

From the Departments of Anesthesiology, Uniformed Services University of the Health Sciences, Walter Reed Army Medical Center, National Naval Medical Center, Bethesda, Maryland.

Address correspondence and reprint requests to John F. Capacchione, MD, Uniformed Services University of the Health Sciences, Department of Anesthesiology, 4301 Jones Bridge Rd., Bethesda, MD 20814. Address e-mail to jcapacchione{at}usuhs.mil.

Abstract

BACKGROUND: Malignant hyperthermia (MH) is a pharmacogenetic disorder of skeletal muscle calcium regulation associated primarily, but not exclusively, with mutations in the skeletal muscle ryanodine receptor. Associated environmental factors, however, may also be important for expression of the syndrome.

METHODS AND RESULTS: A 24-yr-old trauma patient developed a fulminant MH crisis after a 3 minute exposure to sevoflurane. A thorough evaluation of underlying co-morbidities revealed a number of environmental factors that could have altered skeletal muscle calcium regulation, and may have potentially influenced the effects of volatile inhaled anesthetics. Since MH is a syndrome characterized by abnormal skeletal muscle calcium regulation, other factors that alter calcium homeostasis may exacerbate the impact of inhaled MH-triggering drugs.

CONCLUSIONS: While a thorough history of MH episodes in a proband and family is emphasized as part of a complete preanesthetic evaluation, obtaining a history of other environmental entities that may alter calcium regulation may be equally important to knowing the family history.

This article has been cited by other articles:

				J. Parness You're "Hot" from Pumping Iron? Anesth. Analg., March 1, 2009; 108(3): 711 - 713. [Full Text] [PDF]