title: Malignant hyperthermia in Brazil: analysis of hotline activity in 2009.
abstract: OBJECTIVE
  Malignant hyperthermia (MH) is a pharmacogenetic disease that causes abnormal hypermetabolic reaction to halogenated anesthetics and/or depolarizing muscle relaxants. In Brazil, there is a hotline telephone service for MH since 1991, available 24 hours a day in São Paulo. This article analyzes the activity of the Brazilian hotline service for MH in 2009.
  
  
  METHODS
  Prospective analysis of all phone calls made to the Brazilian hotline service for MH from January to December 2009.
  
  
  RESULTS
  Twenty-two phone calls were received: 21 from the South/Southeast region of Brazil and one from the North region. Fifteen calls were requests for general information about MH. Seven were about suspected MH acute episodes, two of which were not considered as MH. In five episodes compatible with MH, all patients received halogenated volatile anesthetics (2, isoflurane; 3, sevoflurane) and one also used succinylcholine; there were four men and one woman, with a mean age of 18 years (2-27). The problems described in the five MH episodes were tachycardia (5), increased expired carbon dioxide (4), hyperthermia (3), acidemia (1), rhabdomyolysis (1), and myoglobinuria (1). One patient received dantrolene. All five patients with MH episodes were follow-up in the intensive care unit and recovered without sequelae. Susceptibility to MH was later confirmed in two patients by in vitro muscle contracture test.
  
  
  CONCLUSIONS
  The number of calls per year in the Brazilian hotline service for MH is still low. The characteristics of MH episode were similar to those reported in other countries. The knowledge of MH in Brazil needs to be increased.
authors.affiliation: MD; PhD; Professor; Department of Anesthesiology, Pain and Intensive Care, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp). Electronic address: halsilva@uol.com.br.
authors.forename: Helga Cristina Almeida
authors.initials: HC
authors.lastname: da Silva
authors.affiliation: RN; MSc Student, Department of Anesthesiology, Pain and Intensive Care, Escola Paulista de Medicina, Unifesp.
authors.forename: Clea dos Santos
authors.initials: Cdos S
authors.lastname: Almeida
authors.affiliation: MD; Department of Anesthesiology, Pain and Intensive Care, Escola Paulista de Medicina, Unifesp.
authors.forename: Julio Cézar Mendes
authors.initials: JC
authors.lastname: Brandão
authors.affiliation: MD; Department of Anesthesiology, Pain and Intensive Care, Escola Paulista de Medicina, Unifesp.
authors.forename: Cleyton Amaral
authors.initials: CA
authors.lastname: Nogueira e Silva
authors.affiliation: MD; Department of Anesthesiology, Pain and Intensive Care, Escola Paulista de Medicina, Unifesp.
authors.forename: Mariana Elisa Pinto
authors.initials: ME
authors.lastname: de Lorenzo
authors.affiliation: MD; Department of Anesthesiology, Pain and Intensive Care, Escola Paulista de Medicina, Unifesp.
authors.forename: Carolina Baeta Neves Duarte
authors.initials: CB
authors.lastname: Ferreira
authors.affiliation: MD; Department of Anesthesiology, Pain and Intensive Care, Escola Paulista de Medicina, Unifesp.
authors.forename: André Hosoi
authors.initials: AH
authors.lastname: Resende
authors.affiliation: MD; Department of Anesthesiology, Pain and Intensive Care, Escola Paulista de Medicina, Unifesp.
authors.forename: Sara Rocha
authors.initials: SR
authors.lastname: Barreira
authors.affiliation: MD; Department of Anesthesiology, Pain and Intensive Care, Escola Paulista de Medicina, Unifesp.
authors.forename: Priscilla Antunes
authors.initials: PA
authors.lastname: de Almeida
authors.affiliation: MD; Department of Anesthesiology, Pain and Intensive Care, Escola Paulista de Medicina, Unifesp.
authors.forename: Leonardo Henrique Cunha
authors.initials: LH
authors.lastname: Ferraro
authors.affiliation: MD; Department of Anesthesiology, Pain and Intensive Care, Escola Paulista de Medicina, Unifesp.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Takeda
authors.affiliation: MD; Department of Anesthesiology, Pain and Intensive Care, Escola Paulista de Medicina, Unifesp.
authors.forename: Kátia Ferreira
authors.initials: KF
authors.lastname: de Oliveira
authors.affiliation: MD; Department of Anesthesiology, Pain and Intensive Care, Escola Paulista de Medicina, Unifesp.
authors.forename: Talitha Gonçalez
authors.initials: TG
authors.lastname: Lelis
authors.affiliation: MD; MSc; Department of Anesthesiology, Pain and Intensive Care, Escola Paulista de Medicina, Unifesp.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Hortense
authors.affiliation: MD; PhD, Department of Anesthesiology, Pain and Intensive Care, Escola Paulista de Medicina, Unifesp.
authors.forename: Marcelo Vaz
authors.initials: MV
authors.lastname: Perez
authors.affiliation: MD; PhD, Professor, Division of Neuromuscular Diseases, Department of Neurology, Escola Paulista de Medicina, Unifesp.
authors.forename: Beny
authors.initials: B
authors.lastname: Schmidt
authors.affiliation: MD; PhD, Professor, Division of Neuromuscular Diseases, Department of Neurology, Escola Paulista de Medicina, Unifesp.
authors.forename: Acary Souza Bulle
authors.initials: AS
authors.lastname: Oliveira
authors.affiliation: MD, PhD, Full Professor of Anesthesiology, Pain and Intensive Care, Escola Paulista de Medicina, Unifesp.
authors.forename: José Luiz Gomes
authors.initials: JL
authors.lastname: do Amaral
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D015277:Hotlines / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D008305:Malignant Hyperthermia / Q000175:diagnosis / Q000453:epidemiology*; D011446:Prospective Studies; D055815:Young Adult
keywords: Adverse Drug Reaction Reporting Systems; Anesthetics/adverse effects; Intraoperative Complications; Malignant Hyperthermia