FULMINANT MALIGNANT HYPERTHERMIA ASSOCIATED WITH KETOACIDOTIC DIABETIC COMA

Malignant hyperthermia (MH) in humans is usually triggered by volatile anaesthetics and depolarizing muscle relaxants. However, other factor s or drugs (e.g. cresol) are thought to induce MH. We report a case of fulminant MH associated with a ketoacidotic diabetic coma. After ther apy for diabetic coma with insulin (containing the preservative cresol ) and electrolyte solutions was started, the patient complained of inc reasing myalgia, developed a high fever and respiratory and metabolic acidosis and lost consciousness. MH was treated immediately with dantr olene; the patient recovered within 14 days. Five months later the pat ient was diagnosed as MH-susceptible by the in vitro caffeine and halo thane contracture test. This case supports the assessment that MH and diabetes are associated diseases and that cresol could possibly trigge r MH. Furthermore, therapy with dantrolene has been demonstrated to be beneficial in the treatment of MH associated with diabetic coma.