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Morphologic abnormalities in a case of malignant hyperthermia
Anesthesiology
|March 1, 1978
Summary
Malignant hyperthermia in a child led to skeletal muscle abnormalities, including numerous enlarged mitochondria and increased lysosomes, identified via biopsy after the anesthetic event.
Area of Science:
- Anesthesiology
- Pediatric Medicine
- Cell Biology
Background:
- Malignant hyperthermia (MH) is a rare, life-threatening pharmacogenetic disorder of skeletal muscle.
- Triggered by volatile anesthetics and succinylcholine, MH presents with hypermetabolism and muscle rigidity.
- This case details a pediatric patient's experience with MH and subsequent muscle pathology.
Observation:
- An 8-year-old boy developed malignant hyperthermia during general anesthesia.
- Clinical signs included fever, cardiac arrhythmias, elevated serum enzymes (SGOT, LDH, CPK), proteinuria, and hemoglobinuria.
- Skeletal muscle biopsy revealed significant ultrastructural abnormalities.
Findings:
- Muscle cells exhibited an abnormally high number of enlarged, irregularly shaped mitochondria.
- Abnormal mitochondrial cristae, increased lysosomes, and elevated lipofuscin were observed.
- Myelin-like bodies were also present in the skeletal muscle cells.
Implications:
- These findings highlight specific ultrastructural muscle changes associated with malignant hyperthermia.
- The observed mitochondrial and lysosomal abnormalities may contribute to MH pathophysiology.
- Further research into muscle cell response to anesthetic triggers is warranted.