McMillan B M, Hirshberg J S, Cosgrove S C
Washington University in St. Louis Missouri USA.
Anaesth Rep. 2019 Aug 19;7(2):73-75. doi: 10.1002/anr3.12022. eCollection 2019 Jul-Dec.
McArdle disease (glycogen storage disease type V) is a rare, autosomal recessive disorder with an incidence of roughly 1:100,000. Despite concern that labour could predispose these patients to muscle damage, there are no evidence-based guidelines for the management of labour and delivery in this population. We describe the case of a nulliparous parturient with both McArdle disease and adenosine monophosphate deaminase 1 deficiency who developed rhabdomyolysis after vaginal delivery. In the absence of common triggers, we believe that prolonged pushing efforts contributed to the increase in postpartum creatinine kinase. There are no previous cases of postpartum rhabdomyolysis after caesarean or assisted vaginal delivery within 45 min. We recommend that practitioners be alert to the possibility of rhabdomyolysis occurring with greater than 2 h of pushing efforts in parturients with McArdle disease.
麦克尔迪氏病（糖原贮积病Ⅴ型）是一种罕见的常染色体隐性疾病，发病率约为1:100,000。尽管有人担心分娩可能使这些患者易发生肌肉损伤，但对于该人群分娩的管理尚无循证指南。我们描述了一例初产妇，患有麦克尔迪氏病和单磷酸腺苷脱氨酶1缺乏症，阴道分娩后发生横纹肌溶解症。在没有常见诱因的情况下，我们认为长时间用力推挤导致产后肌酸激酶升高。此前尚无剖宫产或阴道助产术后45分钟内发生产后横纹肌溶解症的病例。我们建议从业者警惕患有麦克尔迪氏病的产妇在用力推挤超过2小时后发生横纹肌溶解症的可能性。
