Bush A, Dubowitz V
Department of Paediatrics and Neonatal Medicine, Royal Postgraduate Medical School, London, U.K.
Neuromuscul Disord. 1991;1(3):201-4. doi: 10.1016/0960-8966(91)90025-n.
A 6-yr-old boy who presented with brown urine due to myoglobinuria and who was otherwise virtually asymptomatic was diagnosed as having Becker muscular dystrophy on the basis of a greatly elevated creatine kinase, muscle biopsy, dystrophin analysis, and a deletion of exons 3-7 in the dystrophin gene. Fifteen months later, during a general anaesthetic for dental treatment, he had a cardiac arrest associated with acute rhabdomyolysis, hyperkalaemia and hypocalcaemia. He died 4 days later. This case is reported to highlight this rare but potentially fatal complication of anaesthesia in muscular dystrophy, and to discuss possible ways of preventing such a catastrophe.
一名6岁男孩因肌红蛋白尿出现褐色尿液，除此之外几乎没有症状，根据肌酸激酶大幅升高、肌肉活检、肌营养不良蛋白分析以及肌营养不良蛋白基因外显子3 - 7缺失，被诊断为贝克尔型肌营养不良症。15个月后，在牙科治疗的全身麻醉过程中，他发生心脏骤停，伴有急性横纹肌溶解、高钾血症和低钙血症。4天后他死亡。报告该病例是为了强调这种肌营养不良症中罕见但可能致命的麻醉并发症，并讨论预防此类灾难的可能方法。
