[Contracture test with ionophore A 23187 for the diagnosis of malignant hyperthermia]

The results are reported of the contracture test obtained by using the calcium ionophore A 23187 (Calcimycin) in two patients, the son (A) and the mother (B). The past history of patient A revealed the occurrence of an impending malignant hyperthermia crisis during induction of anaesthesia in 1975. The A 23187 contracture test confirmed the presence of the malignant hyperthermia trait in patient A, whose muscle biopsy had been submitted to the caffeine contracture test, according to Ellis' technique, and found to be positive in the presence of 1 mmol of caffeine in the tissue bath; the contracture test could not be completed with a halothane contracture test, due to the impaired viability of the muscle fibres obtained. On the reverse, the mother (patient B) was found to be negative to the tests applied: the caffeine contracture test, the halothane contracture test and the contracture test performed with the calcium ionophore A 23187. It is suggested the A 23187 contracture test be added to the contracture tests as defined by the European Malignant Hyperpyrexia Group. This test could be of great help in identifying the percentage of relatives of MHS ("malignant hyperthermia susceptible") patients found to be MHE ("malignant hyperthermia equivocal").