American Journal of Medicine Studies
ISSN (Print): 2333-8881 ISSN (Online): 2333-889X Website: http://www.sciepub.com/journal/ajms Editor-in-chief: Apply for this position
Open Access
Journal Browser
Go
American Journal of Medicine Studies. 2013, 1(2), 8-10
DOI: 10.12691/ajms-1-2-2
Open AccessCase Report

Malignant Hyperthermia with Disseminated Intravascular Coagulation during Congenital Ptosis Correction: A Case Report

Admir Sinamati1, Albert Kreci1 and Gentian Vyshka2,

1Institute of Legal Medicine, Tirana, Albania

2Faculty of Medicine, University of Medicine, Tirana, Albania

Pub. Date: August 14, 2013

Cite this paper:
Admir Sinamati, Albert Kreci and Gentian Vyshka. Malignant Hyperthermia with Disseminated Intravascular Coagulation during Congenital Ptosis Correction: A Case Report. American Journal of Medicine Studies. 2013; 1(2):8-10. doi: 10.12691/ajms-1-2-2

Abstract

The case of a 10-year old Caucasian boy operated for correction of congenital bilateral ptosis is described. The picture of a malignant hyperthermia complicated with disseminated intravascular coagulation was seen during the surgery, almost twenty minutes after inhalational volatile anesthesia started. The patient was pronounced dead after the third episode of cardiac arrest that did not responded to electrical conversion. Microscopic and macroscopic findings of the autopsy are described as well, with diffuse bleeding and extravasation in almost all vital organs and body cavities. A discussion on the triggering factors and neuromuscular disorders that are particularly prone to get complicated with imputed anesthetic agents is made, with special referral to similar cases found in the literature, since such a complication was initially reported.

Keywords:
halothane congenital ptosis malignant hyperthermia disseminated intravascular coagulation dantrolene

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

Figures

Figure of 4

References:

[1]  Denborough MA, Lovell RRH. Anaesthetic deaths in a family. Lancet 1960; 2: 45-55.
 
[2]  Foster PS, Gesini E, Claudianos C, Hopkinson KC, Denborough MA. Inositol 1, 4, 5-trisphosphate phosphatase deficiency and malignant hyperpyrexia in swine. Lancet. 1989 Jul 15; 2(8655):124-7.
 
[3]  Denborough MA, Ebeling P, King JO, Zapf P. Myopathy and malignant hyperpyrexia. Lancet. 1970 May 30; 1(7657):1138-40.
 
[4]  Nelson TE. Malignant hyperthermia: a pharmacogenetic disease of Ca++ regulating proteins. Curr Mol Med. 2002 Jun; 2(4):347-69.
 
[5]  Manning BM, Quane KA, Ording H, Urwyler A, Tegazzin V, Lehane M, O'Halloran J, Hartung E, Giblin LM, Lynch PJ, Vaughan P, Censier K, Bendixen D, Comi G, Heytens L, Monsieurs K, Fagerlund T, Wolz W, Heffron JJ, Muller CR, McCarthy TV. Identification of novel mutations in the ryanodine-receptor gene (RYR1) in malignant hyperthermia: genotype-phenotype correlation. Am J Hum Genet. 1998 Mar; 62(3):599-609.
 
[6]  Schiemann AH, Dürholt EM, Pollock N, Stowell KM. Sequence capture and massively parallel sequencing to detect mutations associated with malignant hyperthermia. Br J Anaesth. 2013 Jan; 110(1):122-7.
 
[7]  Broman M, Heinecke K, Islander G, Schuster F, Glahn K, Bodelsson M, Treves S, Müller C. Screening of the ryanodine 1 gene for malignant hyperthermia causative mutations by high resolution melt curve analysis. Anesth Analg. 2011 Nov; 113(5):1120-8.
 
[8]  Bandschapp O, Girard T. Malignant hyperthermia. Swiss Med Wkly. 2012 Jul 31; 142:w13652.
 
[9]  Ording H. Incidence of malignant hyperthermia in Denmark. Anesth Analg. 1985; 64:700-704.
 
[10]  Urwyler A, Hartung E. Die Maligne Hyperthermie. Anaesthesist. 1994; 43:557-69.
 
[11]  Ben Abraham R, Adnet P, Glauber V, Perel A. Malignant hyperthermia. Postgrad Med J. 1998 Jan; 74(867):11-7.
 
[12]  Adnet PJ, Krivosic-Horber RM, Haudecoeur G, Reyford HG, Adamantidis MM, Dupuis BA. Diltiazem and nifedipine reduce the in vitro contracture response to halothane in malignant hyperthermia-susceptible muscle. Can J Anaesth. 1990 Jul; 37(5):556-9.
 
[13]  Abolkhair A, Seefelder C. Malignant hyperthermia resolving with discontinuation of sevoflurane alone. Saudi J Anaesth. 2011 Apr; 5(2):229-32.
 
[14]  Lee YS, Kim WY, Lee SH, Baek SM, Ok SJ, Kim JH, Park YC. A case of malignant hyperthermia during anesthesia induction with sevoflurane -A case report-. Korean J Anesthesiol. 2010 Dec; 59 Suppl: S6-8.
 
[15]  Parris WC, Kambam J, Adkins B. Typical and atypical presentation of malignant hyperpyrexia in nonwhite patients. Anesth Prog. 1988 Sep-Oct; 35(5):208-11.
 
[16]  Isaacs H, Barlow MB. Malignant hyperpyrexia. Further muscle studies in asymptomatic carriers identified by creatinine phosphokinase screening. J Neurol Neurosurg Psychiatry. 1973 Apr; 36(2):228-43.
 
[17]  Brislin RP, Theroux MC. Core myopathies and malignant hyperthermia susceptibility: a review. Paediatr Anaesth. 2013 Apr; 25. Doi: 10.1111/pan.12175.
 
[18]  Schwab S, Krieger D, Müllges W, Hamann G, Hacke W. Neurologische Intensivmedizin; Springer-Verlag, Berlin. 1999; pp. 740-742.
 
[19]  Sandhya R, Gupta R, Ashu A. First branchial arch syndrome with central core myopathy presenting with bilateral congenital ptosis. J Indian Med Assoc. 2012 Oct; 110(10):750.
 
[20]  Skaat A, Fabian ID, Spierer A, Rosen N, Rosner M, Ben Simon GJ. Congenital ptosis repair-surgical, cosmetic, and functional outcome: a report of 162 cases. Can J Ophthalmol. 2013 Apr; 48(2):93-8.