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Classification of malignant hyperthermia-equivocal patients by 4-chloro-M-cresol.
Anesth Analg. 1997 Jul; 85(1):149-54.A&A

Abstract

To clarify the contracture response to 4-chloro-m-cresol (4-CmC) in malignant hyperthermia (MH) equivocal (MHE) muscle, we studied the effect of cumulative concentrations of 4-CmC. In vitro contracture test (IVCT) was performed in 35 probands according to the European MH test protocol. Surplus muscle bundles were exposed to 4-CmC (25-200 micromol/L), maintaining each concentration for 4 and 8 min. After 4 min exposure, the contracture increase of MH susceptible (MHS) (n = 7) muscle specimens was significantly (P = 0.05) greater at 50 micromol/L compared with either MHE halothane sensitive (MHEh) (n = 13) or MH normal (MHN) (n = 15) classified patients. Statistically significant differences (P < 0.05) were also found at 75 micromol/L. Exposure for 8 min yielded significant differences at 50 micromol/L only between MHS and MHEh. MHEh muscles revealed a dose-response curve similar to that found in MHN specimens. MHS muscles showed a significantly higher sensitivity to 4-CmC than either MHEh or MHN, and, in the probands tested so far, MHEh and MHN muscles seem to identically respond to 4-CmC, which seems to indicate a normal response in MHEh probands, implying no MH susceptibility. Therefore, 4-CmC might reduce the frequency of MHEh diagnosis based on standard halothane-caffeine IVCT. However, since MHE individuals may also represent an aberrant genetic status, with MH causing defects linked to unknown mutations, it is premature to consider 4-CmC as a solution to the diagnostic uncertainty of the true status of MHE probands. Presently, 4-CmC may provide supplementary information for a more precise phenotypic categorization of MHE individuals.

Authors+Show Affiliations

L. Boltzmann Institute for Experimental Anaesthesiology and Research in Intensive Care Medicine, and Department of Anaesthesiology and General Intensive Care B, University of Vienna, Austria. Hermann.Gilly@AKH-WIEN.AC.ATNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9212139

Citation

Gilly, H, et al. "Classification of Malignant Hyperthermia-equivocal Patients By 4-chloro-M-cresol." Anesthesia and Analgesia, vol. 85, no. 1, 1997, pp. 149-54.
Gilly H, Musat I, Fricker R, et al. Classification of malignant hyperthermia-equivocal patients by 4-chloro-M-cresol. Anesth Analg. 1997;85(1):149-54.
Gilly, H., Musat, I., Fricker, R., Bittner, R. E., Steinbereithner, K., & Kress, H. G. (1997). Classification of malignant hyperthermia-equivocal patients by 4-chloro-M-cresol. Anesthesia and Analgesia, 85(1), 149-54.
Gilly H, et al. Classification of Malignant Hyperthermia-equivocal Patients By 4-chloro-M-cresol. Anesth Analg. 1997;85(1):149-54. PubMed PMID: 9212139.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Classification of malignant hyperthermia-equivocal patients by 4-chloro-M-cresol. AU - Gilly,H, AU - Musat,I, AU - Fricker,R, AU - Bittner,R E, AU - Steinbereithner,K, AU - Kress,H G, PY - 1997/7/1/pubmed PY - 1997/7/1/medline PY - 1997/7/1/entrez SP - 149 EP - 54 JF - Anesthesia and analgesia JO - Anesth Analg VL - 85 IS - 1 N2 - To clarify the contracture response to 4-chloro-m-cresol (4-CmC) in malignant hyperthermia (MH) equivocal (MHE) muscle, we studied the effect of cumulative concentrations of 4-CmC. In vitro contracture test (IVCT) was performed in 35 probands according to the European MH test protocol. Surplus muscle bundles were exposed to 4-CmC (25-200 micromol/L), maintaining each concentration for 4 and 8 min. After 4 min exposure, the contracture increase of MH susceptible (MHS) (n = 7) muscle specimens was significantly (P = 0.05) greater at 50 micromol/L compared with either MHE halothane sensitive (MHEh) (n = 13) or MH normal (MHN) (n = 15) classified patients. Statistically significant differences (P < 0.05) were also found at 75 micromol/L. Exposure for 8 min yielded significant differences at 50 micromol/L only between MHS and MHEh. MHEh muscles revealed a dose-response curve similar to that found in MHN specimens. MHS muscles showed a significantly higher sensitivity to 4-CmC than either MHEh or MHN, and, in the probands tested so far, MHEh and MHN muscles seem to identically respond to 4-CmC, which seems to indicate a normal response in MHEh probands, implying no MH susceptibility. Therefore, 4-CmC might reduce the frequency of MHEh diagnosis based on standard halothane-caffeine IVCT. However, since MHE individuals may also represent an aberrant genetic status, with MH causing defects linked to unknown mutations, it is premature to consider 4-CmC as a solution to the diagnostic uncertainty of the true status of MHE probands. Presently, 4-CmC may provide supplementary information for a more precise phenotypic categorization of MHE individuals. SN - 0003-2999 UR - https://www.unboundmedicine.com/medline/citation/9212139/Classification_of_malignant_hyperthermia_equivocal_patients_by_4_chloro_M_cresol_ DB - PRIME DP - Unbound Medicine ER -