Newly Published
Editorial Views  |   July 2019
Mission Impossible or Mission Futile?: Estimating Penetrance for Malignant Hyperthermia
Author Notes
  • From the Leeds Institute of Medical Research at St. James’s, University of Leeds (M.-A.S., P.M.H.), and the Malignant Hyperthermia Unit, St. James’s University Hospital (P.M.H.), Leeds, United Kingdom.
  • Accepted for publication June 14, 2019.
    Accepted for publication June 14, 2019.×
  • Correspondence: Address correspondence to Dr. Hopkins: p.m.hopkins@leeds.ac.uk
Article Information
Editorial Views / Patient Safety
Editorial Views   |   July 2019
Mission Impossible or Mission Futile?: Estimating Penetrance for Malignant Hyperthermia
Anesthesiology Newly Published on July 12, 2019. doi:10.1097/ALN.0000000000002884
Anesthesiology Newly Published on July 12, 2019. doi:10.1097/ALN.0000000000002884
In this issue of Anesthesiology, Ibarro Moreno et al.1  report a multicenter evaluation of previous anesthetic history of patients who have a history of malignant hyperthermia (MH) under anesthesia and their family members. This work will have involved considerable effort to collate the data and evaluate the clinical histories. The major and vital clinical message is to reinforce that MH can occur in patients who have previously experienced uneventful anesthesia with MH-triggering anesthetics. The implication is that a negative personal anesthesia history does not obviate the need to take a family history of adverse anesthesia events, nor should it lower the anesthesiologist’s index of suspicion concerning the potential for the patient to develop MH. There are several other interesting observations contained within the data generated by Ibarro Moreno et al.,1  one being that the well-known male predominance of MH probands cannot be explained by different levels of exposure to MH triggering anesthesia, but it is one of their key aims—the estimate of penetrance of variants in the RYR1 gene (the gene encoding the skeletal muscle isoform of the ryanodine receptor, which is the gene principally implicated in MH)—that requires comment.