Hyperglycemia as an atypical finding of malignant hyperthermia: A case report and literature review

Malignant hyperthermia (MH) is a rare but life-threatening disorder induced by volatile anesthetics or depolarizing muscle relaxants. Studies have reported the increased prevalence of hyperglycemia among patients susceptible to MH. Herein, we present the case of a 13-month-old toddler who had successfully undergone dextro-transposition of the great arteries and required main and bilateral pulmonary artery augmentation because of residual pulmonary atresia. The patient exhibited atypical manifestations of MH including hyperglycemia with an inadequate insulin response during the perioperative period. The hyperglycemia resolved following administration of dantrolene, the antidote for MH. Research has associated intracellular calcium leaks with reduced glucose storage in human muscle. Metabolic alterations in patients susceptible to MH may predispose them to hyperglycemia during acute MH episodes.