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[Malignant hyperthermia in a black child. A case report]

J M Hugo, M J Ungerer, F R Erasmus

    South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
    |May 20, 1978
    PubMed
    Summary

    Malignant hyperthermia (MH) is a rare, life-threatening reaction to anesthesia. This case highlights MH in a Black boy, emphasizing its link to musculoskeletal abnormalities and successful treatment.

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    Area of Science:

    • Anesthesiology
    • Pediatric Surgery
    • Clinical Genetics

    Background:

    • Malignant hyperthermia (MH) is a pharmacogenetic disorder of skeletal muscle.
    • It is a critical complication of general anesthesia, particularly with volatile anesthetics and succinylcholine.
    • MH susceptibility is associated with specific genetic mutations and certain musculoskeletal disorders.

    Observation:

    • A Black boy developed malignant hyperthermia during cleft palate repair under halothane anesthesia.
    • The patient presented with a temperature of 41°C and generalized muscle rigidity.
    • Despite a controlled environment, hyperthermia developed rapidly.

    Findings:

    • Serum creatine phosphokinase levels were significantly elevated (630 IU/L) and decreased over 14 days.

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  • Muscle biopsy revealed variation in muscle fiber size, myofibrillar disruption, and basement membrane folding.
  • In vitro muscle studies confirmed MH susceptibility with severe contraction upon exposure to halothane.

    • Implications:

    • This case underscores the importance of recognizing MH triggers and risk factors, including musculoskeletal abnormalities, in diverse populations.
    • Prompt diagnosis and multimodal treatment, including procainamide and supportive care, are crucial for patient survival.
    • Further research into the genetic and phenotypic variability of MH is warranted for improved patient management.