Abstract
We report a patient with Duchenne muscular dystrophy who developed malignant hyperpyrexia during general anaesthesia. During anaesthesia bradycardia was followed by ventricular fibrillation, on which ventricular flutter supervened and a body temperature rise of 0.6°C for 15 minutes, myoglobinuria and elevation of CPK level were observed. The caffeine sensitivity test of biopsied muscle fibers revealed an increase in sensitivity, although there was no sign of muscle rigidity during or after anaesthesia. Diagnosis of Duchenne muscular dystrophy was first established after the development of malignant hyperpyrexia in the present case as well as in previously reported cases. Determination of serum CPK is very important before general anaesthesia.
Résumé
Les auteurs rapportent le cas d’un malade souffrant de dystrophie musculaire progressive type Duchenne qui développa une hyperpyrexie maligne pendant l’anesthésie générale. Une bradycardie évolua en fibrillation ventriculaire qui se transforma par la suite en flutter ventriculaire pendant que la température corporelle s’élevait de 0.6 C pendant 15 minutes. Une myoglobinurie et une élévation des taux de C.P.K. ont été observées. La sensibilité à la caféïne sur les fibres musculaires preélevées était augmentée bien qu’on n’ait pas observé de rigidité pendant et après l’anesthésie. Le diagnostic de dystrophie musculaire progressive type Duchenne a été porté dans le cas présent après la crise a“hyperpyrexie maligne. Le dosage des C.P.K. est une analyse importante avant une intervention.
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Oka, S., Igarashi, Y., Takagi, A. et al. Malignant hyperpyrexia and duchenne muscular dystrophy: A case report. Canad. Anaesth. Soc. J. 29, 627–629 (1982). https://doi.org/10.1007/BF03007752
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DOI: https://doi.org/10.1007/BF03007752