Table of Contents  
COMMENTARY
Year : 2014  |  Volume : 7  |  Issue : 3  |  Page : 383-384  

Malignant hyperthermia


Department of Anaesthesiology and Intensive Care, Maulana AzadMedical College and Associated LN Hospital, New Delhi, India

Date of Web Publication18-Mar-2014

Correspondence Address:
Kirti N Saxena
B-302, Geetanjali Apartments, Vikas Marg Extension, New Delhi - 110 092
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Saxena KN. Malignant hyperthermia. Med J DY Patil Univ 2014;7:383-4

How to cite this URL:
Saxena KN. Malignant hyperthermia. Med J DY Patil Univ [serial online] 2014 [cited 2019 Dec 10];7:383-4. Available from: http://www.mjdrdypu.org/text.asp?2014/7/3/383/128995

Denborough et al. reported the first case of malignant hyperthermia (MH) in 1960. A local family was described in which 10 deaths were attributable to general anesthesia. It was concluded even then that "the pattern of inheritance of the abnormality is compatible with that due to an incompletely penetrant dominant gene or genes." [1]

The authors report one more case of MH from India, adding to the existing literature. [2],[3],[4],[5],[6]

The diagnosis of MH is based on clinical presentation, contracture test, and genetic studies. Of these methods, clinical presentation can be the diagnosing tool only after an episode of MH has occurred. Contracture tests are extremely difficult to conduct, and Larach et al. [7] recommended that diagnostic muscle biopsies should not be performed until a minimum of 10 normal control patients have been tested and found to be normal by the new laboratory. Genetic testing is the most promising method that can predict susceptibility to MH before an episode occurs. A study has demonstrated that the use of genetic data to determine MH susceptibility status led to a 99.5% [8] sensitivity for the in vitro contracture test. Genetic testing requires only a blood sample of the patient and is without risk to any individual. It is very expensive and presently done only in the metro cities of India. Seeing this scenario, it is reiterated that genetic testing should be available in all medical colleges of India. Genetic laboratories are the order of the day as medical conditions are increasingly being linked to the genetic makeup of individuals and even treatment is being decided by it.

The treatment of MH is a vexed issue and is linked to its early diagnosis. While Dantrolene is not necessary for treatment, [3] it remains the drug of choice and is now available in India. Anesthesiologists in India need to be on the forefront of demanding its availability in all centers.

 
  References Top

1.Denborough MA, Lovell R. Anesthetic deaths in a family. Lancet 1960;2:45.  Back to cited text no. 1
    
2.Punj J, Bhatnagar S, Saxena A. Malignant hyperthermia in the Indian Subcontinent: Non-availability of dantrolene - A cause for concern? Int J Pharmacol 2001;1:1.  Back to cited text no. 2
    
3.Saxena KN, Dua CK. Malignant Hyperthermia - A Case Report. Indian J Anaesth 2007;51:534-5.  Back to cited text no. 3
  Medknow Journal  
4.Gupta PK, Hopkins PM. Malignant Hyperthermia in India. Anaesthesia. 2010;65:1059-68.   Back to cited text no. 4
    
5.Jain G, Singh DK, Yadav G. Malignant Hyperthermia in endosulfan poisoning. Toxicol Int 2012;19:74-6.  Back to cited text no. 5
[PUBMED]  Medknow Journal  
6.Gupta D, Ramakant, Singh PK. Postoperative hyperpyrexia: Retracing malignant hyperthermia. J Anaesthesiol Clin Pharmacol 2012;28:405-6.  Back to cited text no. 6
[PUBMED]  Medknow Journal  
7.Larach MG. Standardization of the caffeine halothane muscle contracture test. North American Malignant Hyperthermia Group. Anesth Analg 1989;69:511-5.  Back to cited text no. 7
[PUBMED]    
8.Monnier N, Kozak-Ribbens G, Krivosic-Horber R, Nivoche Y, Qi D, Kraev N, et al. Hum Mutat 2005;26:413-25.  Back to cited text no. 8
    




 

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