title: [Malignant hyperthermia in a black child. A case report].
abstract: A case of malignant hyperthermia in a Black boy is presented. He developed this condition during repair of a cleft palate, with halothane as the triggering agent. The importance of the high incidence of malignant hyperthermia in patients with certain musculoskeletal abnormalities is stressed. Despite a cool and well air-conditioned theatre, the patient's temperature was 41 degree C when the condition was suspected. At that stage general muscle rigidity was present. The patient was successfully treated with procainamide, sodium bicarbonate and hydrocortisone; surface cooling (with ice packs) was instituted and the stomach was washed out with ice-cold Ringer's solution. Over a period of 14 days serum creatine phosphokinase values decreased from 630 IU (on the day of the incident) to 12 IU. A muscle biopsy showed variation in muscle fibre size. Electron microscopical studies showed myofibrillar disruption and folding of the basement membrane. A modified version of Denborough's technique was used for the in vitro exposure of muscle strips to halothane and suxamethonium. Isometric contraction was measured and recorded. A severe contraction followed the exposure of muscle strips to halothane, which confirmed the diagnosis.
mesh_terms: D002648:Child; D003402:Creatine Kinase / Q000097:blood / Q000235:genetics; D003452:Cryosurgery; D006221:Halothane / Q000009:adverse effects; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D066298:In Vitro Techniques; D008297:Male; D008305:Malignant Hyperthermia / Q000139:chemically induced / Q000188:drug therapy; D009132:Muscles / Q000187:drug effects; D011342:Procainamide / Q000627:therapeutic use
chemical_list: D003402:Creatine Kinase; D011342:Procainamide; D006221:Halothane; D006854:Hydrocortisone
vernacular_title: Maligne hipertermie in 'n Swart kind. 'n Gevalbespreking.