Acute life-threatening arrhythmias caused by severe hyperkalemia after induction of anesthesia in an infant with methylmalonic acidemia

Pei Wen Chao, Wen Kuei Chang, Wen I. Lai, Chinsu Liu, Kwok Hon Chan, Cheng Ming Tsao

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Methylmalonic acidemia (MMA) is a very rare genetic disease of metabolism that progressively leads to neurological and renal sequelae. This report describes an unusual case of a patient with MMA who developed severe hyperkalemia and severe dysrhythmia during anesthesia. A 13-month-old male infant with MMA underwent urgent insertion of a port-a-cath under general anesthesia. A life-threatening arrhythmia suddenly occurred, with severe hyperkalemia (up to 7.4 mmol/L), immediately following induction of anesthesia. Emergent resuscitation was successfully carried out, with a complete neurological recovery after 7 days after surgery. Although MMA is a rare complication, the possibility of severe hyperkalemia should be considered in the differential diagnosis of patients with MMA presenting with wide QRS complex tachycardia. The management and intraoperative complications of this disorder are reported here, and the available literature is reviewed.

Original languageEnglish
Pages (from-to)243-245
Number of pages3
JournalJournal of the Chinese Medical Association
Volume75
Issue number5
DOIs
Publication statusPublished - May 1 2012
Externally publishedYes

Fingerprint

Hyperkalemia
Cardiac Arrhythmias
Anesthesia
Inborn Genetic Diseases
Intraoperative Complications
Rare Diseases
Ambulatory Surgical Procedures
Tachycardia
Resuscitation
General Anesthesia
Differential Diagnosis
Methylmalonic acidemia
Kidney

Keywords

  • Anesthesia
  • Arrhythmia
  • Hyperkalemia
  • Methylmalonic acidemia
  • Resuscitation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Acute life-threatening arrhythmias caused by severe hyperkalemia after induction of anesthesia in an infant with methylmalonic acidemia. / Chao, Pei Wen; Chang, Wen Kuei; Lai, Wen I.; Liu, Chinsu; Chan, Kwok Hon; Tsao, Cheng Ming.

In: Journal of the Chinese Medical Association, Vol. 75, No. 5, 01.05.2012, p. 243-245.

Research output: Contribution to journalArticle

Chao, Pei Wen ; Chang, Wen Kuei ; Lai, Wen I. ; Liu, Chinsu ; Chan, Kwok Hon ; Tsao, Cheng Ming. / Acute life-threatening arrhythmias caused by severe hyperkalemia after induction of anesthesia in an infant with methylmalonic acidemia. In: Journal of the Chinese Medical Association. 2012 ; Vol. 75, No. 5. pp. 243-245.
@article{91866b8d37ee40b8be8c127d504ac4ab,
title = "Acute life-threatening arrhythmias caused by severe hyperkalemia after induction of anesthesia in an infant with methylmalonic acidemia",
abstract = "Methylmalonic acidemia (MMA) is a very rare genetic disease of metabolism that progressively leads to neurological and renal sequelae. This report describes an unusual case of a patient with MMA who developed severe hyperkalemia and severe dysrhythmia during anesthesia. A 13-month-old male infant with MMA underwent urgent insertion of a port-a-cath under general anesthesia. A life-threatening arrhythmia suddenly occurred, with severe hyperkalemia (up to 7.4 mmol/L), immediately following induction of anesthesia. Emergent resuscitation was successfully carried out, with a complete neurological recovery after 7 days after surgery. Although MMA is a rare complication, the possibility of severe hyperkalemia should be considered in the differential diagnosis of patients with MMA presenting with wide QRS complex tachycardia. The management and intraoperative complications of this disorder are reported here, and the available literature is reviewed.",
keywords = "Anesthesia, Arrhythmia, Hyperkalemia, Methylmalonic acidemia, Resuscitation",
author = "Chao, {Pei Wen} and Chang, {Wen Kuei} and Lai, {Wen I.} and Chinsu Liu and Chan, {Kwok Hon} and Tsao, {Cheng Ming}",
year = "2012",
month = "5",
day = "1",
doi = "10.1016/j.jcma.2012.03.004",
language = "English",
volume = "75",
pages = "243--245",
journal = "Journal of the Chinese Medical Association",
issn = "1726-4901",
publisher = "Elsevier Taiwan LLC",
number = "5",

}

TY - JOUR

T1 - Acute life-threatening arrhythmias caused by severe hyperkalemia after induction of anesthesia in an infant with methylmalonic acidemia

AU - Chao, Pei Wen

AU - Chang, Wen Kuei

AU - Lai, Wen I.

AU - Liu, Chinsu

AU - Chan, Kwok Hon

AU - Tsao, Cheng Ming

PY - 2012/5/1

Y1 - 2012/5/1

N2 - Methylmalonic acidemia (MMA) is a very rare genetic disease of metabolism that progressively leads to neurological and renal sequelae. This report describes an unusual case of a patient with MMA who developed severe hyperkalemia and severe dysrhythmia during anesthesia. A 13-month-old male infant with MMA underwent urgent insertion of a port-a-cath under general anesthesia. A life-threatening arrhythmia suddenly occurred, with severe hyperkalemia (up to 7.4 mmol/L), immediately following induction of anesthesia. Emergent resuscitation was successfully carried out, with a complete neurological recovery after 7 days after surgery. Although MMA is a rare complication, the possibility of severe hyperkalemia should be considered in the differential diagnosis of patients with MMA presenting with wide QRS complex tachycardia. The management and intraoperative complications of this disorder are reported here, and the available literature is reviewed.

AB - Methylmalonic acidemia (MMA) is a very rare genetic disease of metabolism that progressively leads to neurological and renal sequelae. This report describes an unusual case of a patient with MMA who developed severe hyperkalemia and severe dysrhythmia during anesthesia. A 13-month-old male infant with MMA underwent urgent insertion of a port-a-cath under general anesthesia. A life-threatening arrhythmia suddenly occurred, with severe hyperkalemia (up to 7.4 mmol/L), immediately following induction of anesthesia. Emergent resuscitation was successfully carried out, with a complete neurological recovery after 7 days after surgery. Although MMA is a rare complication, the possibility of severe hyperkalemia should be considered in the differential diagnosis of patients with MMA presenting with wide QRS complex tachycardia. The management and intraoperative complications of this disorder are reported here, and the available literature is reviewed.

KW - Anesthesia

KW - Arrhythmia

KW - Hyperkalemia

KW - Methylmalonic acidemia

KW - Resuscitation

UR - http://www.scopus.com/inward/record.url?scp=84861532356&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84861532356&partnerID=8YFLogxK

U2 - 10.1016/j.jcma.2012.03.004

DO - 10.1016/j.jcma.2012.03.004

M3 - Article

VL - 75

SP - 243

EP - 245

JO - Journal of the Chinese Medical Association

JF - Journal of the Chinese Medical Association

SN - 1726-4901

IS - 5

ER -