[Comparative study of in vitro diagnosis by the skinned fiber test and clinical diagnosis of malignant hyperthermia].
Skeletal muscles from twenty patients suspected of malignant hyperthermia during general anesthesia were examined with the skinned fiber test for abnormality in the Ca2+ release function of their sarcoplasmic reticulum, and the result was correlated with the classifications of the patients in accordance with the clinical criteria now used in Japan. Among them, fourteen patients were diagnosed as clinical malignant hyperthermia syndrome (fulminant syndrome: 4, abortive syndrome: 10). Three out of four fulminant cases showed potentiated Ca-induced Ca release mechanism of the sarcoplasmic reticulum in their skeletal muscles. The others including six patients not diagnosed as malignant hyperthermia were normal in the sarcoplasmic reticulum function. This suggests that the skinned fiber test has comparatively high sensitivity to fulminant malignant hyperthermia syndrome. The present paper discusses, based on the present results, the problems resulting from the difference in diagnostic concept between in vitro criteria by the skinned fiber test to detect a specific pathogenetical factor in the skeletal muscle of a single abnormality and clinical criteria to pick up a series of relatively non-specific symptoms and signs of a clinical syndrome.
Matsui
K
K
Fujioka
Y
Y
Mukaida
K
K
Takahashi
M
M
Kikuchi
H
H
Fujii
K
K
Morio
M
M
D000293:Adolescent; D000328:Adult; D000768:Anesthesia, General / Q000009:adverse effects; D002118:Calcium / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008305:Malignant Hyperthermia / Q000175:diagnosis* / Q000209:etiology; D008722:Methods; D008875:Middle Aged; D009132:Muscles / Q000187:drug effects / Q000378:metabolism*; D011237:Predictive Value of Tests; D012519:Sarcoplasmic Reticulum / Q000187:drug effects / Q000378:metabolism
D002118:Calcium