Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024591 (malignant hyperthermia)
 2,353 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Despite the introduction of a number of new injectable agents, ultrashort barbiturates continue to be popular. Some of the reasons include rapid, smooth onset of action; predictable hypnotic effects; relatively rapid, smooth recovery; and inexpensiveness. Ultrashort barbiturates also possess some pharmacodynamic properties that make them ideal agents for use in patients with certain diseases or undergoing certain procedures. These include patients with raised intracranial pressure, patients with a history of seizures, patients with corneal lacerations or glaucoma, patients for examination of vocal cord and arytenoid cartilage function, patients with hyperthyroidism, and patients thought to be susceptible to malignant hyperthermia.
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PMID:Advantages and guidelines for using ultrashort barbiturates for induction of anesthesia. 158 46

Rhabdomyolysis, a term used to describe the rapid breakdown of striated muscle, is characterized by rupture and necrosis of muscle fibers. This process results in the release of cell breakdown products into the bloodstream and extracellular space. Although direct muscle injury remains the most common cause of muscle injury, additional causes include hereditary enzyme disorders, drugs, toxins, endocrinopathies, malignant hyperthermia, neuroleptic malignant syndrome, heatstroke, hypothermia, electrolyte alterations, diabetic ketoacidosis and non-ketotic hyperosmolar coma, severe hypo- or hyperthyroidism and bacterial or viral infections. The classic triad of symptoms includes muscle pain, weakness and dark urine, although more than 50% of the patients do not complain of muscle pain or weakness. Additional systemic symptoms include fever, general malaise, tachycardia, nausea and vomiting. The laboratory diagnosis is based essentially on the measurement of creatine kinase in serum or plasma. Plasma and urine myoglobin measurement might be useful in the early stages of the syndrome and for identifying a subset of patients with minor skeletal muscle injury. Patient monitoring is pivotal (the mortality rate is as high as 8%), and should be focused on preventing the detrimental consequences, that often include renal disease and coagulopathy. In the pre-hospital setting, forced hydration with 1.5-2 L of sterile saline solution should be started immediately, followed by 1.5-2 L/h. Following hospital admission, continuous hydration should be ensured, alternating the saline solution with a 5% glucose solution. In the presence of myoglobinuria, urine should be alkalinized by use of sodium bicarbonate solution. Clin Chem Lab Med 2010;48:749-56.
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PMID:Rhabdomyolysis: historical background, clinical, diagnostic and therapeutic features. 2044 60

Thyroid storm, a severe complication of hyperthyroidism, can be a devastating medical emergency requiring rapid management. Intraoperative thyrotoxicosis, a hypermetabolic syndrome with increased thyroid hormone levels, also presents a challenging scenario. Clinical suspicion is key along with eliminating other potentially catastrophic emergencies such as malignant hyperthermia or pheochromocytoma. In this case report, we describe a 15-year-old male undergoing halo traction placement for displaced dens and C1 fractures. Preoperative tachycardia and a history suggestive of hyperthyroidism raised our clinical suspicion for thyrotoxicosis when hypertension and tachycardia developed after induction of anesthesia.
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PMID:Intraoperative diagnosis and treatment of thyroid storm in a 15-year-old male. 2561 58

Malignant hyperthermia and thyroid storm are intraoperative emergencies with overlapping symptoms but different treatment protocols. We faced this diagnostic dilemma in a 25-year-old patient with symptomatic hyperthyroidism, elevated free T3 and free T4, and low thyroid-stimulating hormone from Graves disease despite treatment with propranolol 80 mg daily and methimazole 40 mg every 8 hours. During thyroidectomy, he developed hyperthermia and hypercarbia without tachycardia. When the rate of rise of PaCO2 and temperature accelerated, we treated the patient for malignant hyperthermia, a diagnosis subsequently confirmed by genetic testing.
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PMID:Malignant Hyperthermia Versus Thyroid Storm in a Patient With Symptomatic Graves Disease: A Case Report. 2902 38