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Morphologic abnormalities in a case of malignant hyperthermia.

M T Hull, J Muller, W H Albrecht

    Anesthesiology
    |March 1, 1978
    PubMed
    Summary
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    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.

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  • 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.