Malignant hyperthermia testing in patients with persistently increased serum creatine kinase levels

被引:54
作者
Weglinski, MR
Wedel, DJ
Engel, AG
机构
[1] MAYO CLIN & MAYO FDN,DEPT NEUROL,ROCHESTER,MN 55905
[2] MAYO CLIN & MAYO FDN,MAYO MED SCH,ROCHESTER,MN 55905
关键词
D O I
10.1097/00000539-199705000-00016
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
We describe 49 neurologically asymptomatic patients with persistently increased serum creatine kinase (CK) levels (idiopathic hyperCKemia or IHCK) who were referred to our institution for diagnostic muscle biopsy, including malignant hyperthermia (MH) susceptibility testing between 1979 and 1993. Muscle biopsy samples of the vastus lateralis were obtained for histologic analysis and MH contracture testing with halothane and caffeine. From 1979 to November 1987, patients were tested for MH in accordance with a standardized institutional protocol. After November 1987, contracture testing was performed according to the recently adopted North American MH Group protocol. In both protocols, a patient was considered to be MH susceptible (MHS) if one or more muscle strip demonstrated an abnormal contracture response after exposure to 3% halothane, 2% halothane, or caffeine alone. Twenty-four of the 49 IHCK patients (49%) had positive contracture tests. No significant correlation was found between the magnitude of CK increase and the incidence of MHS or histologic abnormalities. Unexplained persistently increased CK levels in an otherwise healthy patient should alert the anesthesiologist to the possibility of MI-IS and/or myopathy.
引用
收藏
页码:1038 / 1041
页数:4
相关论文
共 16 条
[1]   EVALUATION OF CREATININE PHOSPHOKINASE SCREENING AS A PREDICTOR OF MALIGNANT HYPERTHERMIA - A PROSPECTIVE-STUDY [J].
AMARANATH, L ;
LAVIN, TJ ;
TRUSSO, RA ;
BOUTROS, AR .
BRITISH JOURNAL OF ANAESTHESIA, 1983, 55 (06) :531-533
[2]  
BIRMINGHAM PK, 1989, ANESTH ANALG, V69, P846
[3]   UNEXPECTED HYPERTHERMIA MANIFESTING DURING OUTPATIENT ANESTHESIA [J].
BRAUDE, BM ;
PRESS, P ;
MOYES, DG ;
ISAACS, H ;
DANILEWITZ, MD ;
KOLB, ME .
ANESTHESIOLOGY, 1986, 64 (05) :647-650
[4]  
BRITT BA, 1976, CAN ANAESTH SOC J, V23, P263
[5]   EVALUATION OF CREATININE PHOSPHOKINASE IN SCREENING PATIENTS FOR MALIGNANT HYPERPYREXIA [J].
ELLIS, FR ;
CLARKE, IMC ;
MODGILL, M ;
CURRIE, S ;
HARRIMAN, DGF .
BRITISH MEDICAL JOURNAL, 1975, 3 (5982) :511-513
[6]  
GRONERT GA, 1979, ANESTH ANALG, V58, P367
[7]   HALOTHANE-CAFFEINE CONTRACTURE TESTING IN NEUROMUSCULAR DISEASES [J].
HEIMANPATTERSON, TD ;
ROSENBERG, H ;
FLETCHER, JE ;
TAHMOUSH, AJ .
MUSCLE & NERVE, 1988, 11 (05) :453-457
[8]  
HOGAN K, 1992, ANESTH ANALG, V75, P441
[9]   EVIDENCE FOR RELATED MYOPATHIES IN EXERTIONAL HEAT-STROKE AND MALIGNANT HYPERTHERMIA [J].
HOPKINS, PM ;
ELLIS, FR ;
HALSALL, PJ .
LANCET, 1991, 338 (8781) :1491-1492
[10]  
LARACH MG, 1989, ANESTH ANALG, V69, P511