Trauma, systemic inflammatory response syndrome, dietary supplements, illicit steroid use and a questionable malignant hyperthermia reaction.

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.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Capacchione JF,Radimer MC,Sagel JS,Kraus GP,Sambuughin N,Muldoon SM

doi

10.1213/ane.0b013e31819240a5

subject

Has Abstract

pub_date

2009-03-01 00:00:00

pages

900-3

issue

3

eissn

0003-2999

issn

1526-7598

pii

108/3/900

journal_volume

108

pub_type

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