Morphologic Abnormalities in a Case of Malignant Hyperthermia

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Abstract
An 8 yr old boy underwent general anesthesia and experienced an episode of malignant hyperthermia, characterized by elevated temperature, cardiac arrhythmias, markedly elevated serum enzymes (SGOT [serum glutamic oxaloacetic transaminase], LDH [lactate dehydrogenase] and CPK [creatine phosphokinase]), proteinuria and hemoglobinuria. Sixty-six days after anesthesia a skeletal muscle biopsy was obtained for examination by light microscopy and EM, which showed skeletal muscle cells with abnormally numerous mitochondria, enlarged and variable in shape. Some contained abnormal cristae. There were more lysosomes than normal, and lipofuscin was increased in quantity. Myelin-like bodies were also present. Previous reports of muscle abnormalities are reviewed and compared with the data in this case.