Nonmalignant hyperthermia and malignant hyperthermia confused.
Nonmalignant hyperthermia and malignant hyperthermia confused.
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非恶性高热与恶性高热混淆。
DOI：
10.1016/j.jclinane.2008.01.005
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发表时间：
2008
影响因子：
6.7
通讯作者：
Miller,Jordan
中科院分区：
文献类型：
--
作者：
Parness,Jerome;Herlich,Andrew;Torp,KlausD;Larach,MarilynG;Miller,Jordan
这封信是对Amir R. Baluch和Sanjay P. Oommen [1]。我们质疑在标题中使用“恶性高热”一词，而不是报告参考文献1中使用的不太确定但更合适的“恶性高热样综合征”一词。MH没有特异性体征，许多不同的病理生理状态可能与MH相似。事实上，该杂志发表了这样一个案例，标题为“非恶性高热诱导麻醉的儿科患者接受双向格伦手术”[2]。目前唯一可用的MH的确定性测试是骨骼肌细胞内Ca 2+释放通道，1型兰尼碱受体（RYR 1）中已知致病突变的遗传测试（见www. emhg。org获取这些突变的列表），或者，在北美，对活肌肉活检样本进行咖啡因-氟烷挛缩测试[3]。不幸的是，病人去世了，据报道没有死后材料被送往基因检测。如果作者成功地用丹曲林治疗了患者的发热，则MH作为病因的分配可能更站得住脚[4]。然而，据报道，丹曲林既能改善脓毒症的影响[5]，又能作为解热剂[6，7]，因此，
This letter is in response to the recent case report,“Malignant hyperthermia associated with diabetic hyperosmolar hyperglycemic nonketotic state in a young man”, by Amir R. Baluch and Sanjay P. Oommen [1]. We question the declarative use of the term “malignant hyperthermia” in the title, rather than the less certain, and more appropriate, term “malignant hyperthermia-like syndrome”, as used in Reference 1 of the report. There are no pathognomonic signs of MH, and a number of different pathophysiological states may mimic MH. Indeed, this journal published such a case entitled “Nonmalignant hyperthermia on induction of anesthesia in a pediatric patient undergoing bi-directional Glenn procedure”[2]. The only definitive tests for MH available at present are a genetic test for known causative mutations in the skeletal muscle intracellular Ca2+ release channel, the type 1 ryanodine receptor (RYR1)(see www. emhg. org for a list of these mutations), or, in North America, a live muscle biopsy specimen subjected to a caffeine-halothane contracture test [3]. Unfortunately, the patient expired, and no post-mortem material was reported to have been sent for genetic testing. Had the authors successfully treated the patient’s fever with dantrolene, the assignment of MH as the cause might be more tenable [4]. However, dantrolene has been reported both to ameliorate the effects of sepsis [5] and act as an antipyretic [6, 7], so that