dantrolene / Generic mfg. - LARVOL DELTA

Case Report: Paralytic ileus as an early manifestation of evolving neuroleptic malignant syndrome in a patient receiving anti-psychotics. (PubMed, Front Med (Lausanne)) - "This atypical and underreported presentation highlights the importance of maintaining a high index of suspicion for NMS in patients receiving antipsychotic therapy who develop unexplained gastrointestinal dysmotility. Prompt recognition, immediate discontinuation of the offending antipsychotic agent, and early initiation of treatment with dantrolene and bromocriptine resulted in a favorable clinical outcome."

Journal • CNS Disorders

Brief Report: A cardiac surgery protocol for suspected malignant hyperthermia. (PubMed, Turk Gogus Kalp Damar Cerrahisi Derg) - "No clinical or biochemical evidence of MH occurred. We outline this structured approach as a practical reference for the cardiac surgical community."

Journal • Anesthesia • Cardiovascular

Spinal anesthesia for urgent cesarean section in a parturient with RYR1 mutation-associated malignant hyperthermia susceptibility: a case report. (PubMed, Matern Health Neonatol Perinatol) - "This case demonstrates that spinal anesthesia is a safe and effective trigger-free technique for urgent cesarean section in MH-susceptible parturient when strict precautions are followed. Pre-pregnancy genetic diagnosis enabled prospective multidisciplinary planning and contributed to excellent maternal and neonatal outcomes."

Journal • Anesthesia • Genetic Disorders • Pain • RYR1

CF102. Extreme Hyperthermia...but Is It Malignant Hyperthermia? MH Experts Opine (1 CME) (ASA 2026) - "This clinical forum is comprised of four physician consultants for the malignant hyperthermia (MH) hotline of MHAUS. We hope to increase learners' confidence in the care of patients during MH or MH-like events. SessionLearningObjective1: Identify the signs and symptoms of an MH crisis.SessionLearningObjective2: Differentiate between true MH and other mimicking disease processes that cause severe hyperthermia.SessionLearningObjective3: Identify the role of dantrolene in differential diagnosis of MH and its potential use in other causes of severe hyperthermia."

Neuroleptic Malignant Syndrome (PubMed, Medicina (B Aires)) - "Management relies on immediate discontinuation of the offending agent, intensive supportive care, and, in moderate to severe cases, pharmacological treatment with benzodiazepines, dopaminergic agents such as bromocriptine or amantadine, and muscle relaxants such as dantrolene. Early recognition and timely treatment are crucial to ensure favorable outcomes and reduce morbidity and mortality."

Journal • Review • CNS Disorders • DRD2

Functional Characterization of Patient-Derived Myotubes Carrying ANO5 and ORAI3 Variants in RYR1-Negative Malignant Hyperthermia Susceptibility. (PubMed, Genes (Basel)) - "In contrast, dantrolene-induced Ca2+ reduction was significantly greater only in the RYR1 variant group. These findings suggest that ANO5 and ORAI3 variants may contribute to abnormal Ca2+ regulation in MH-susceptible individuals without RYR1 mutations and highlight the importance of combining genomic analysis with functional validation to identify novel genetic contributors to MH susceptibility."

Journal • Genetic Disorders • ANO 5 • RYR1

Heat On The Pump: Malignant Hyperthermia During Cardiopulmonary Bypass (ASA 2026) - "Postoperatively, the patient experienced recrudescence requiring additional dantrolene. This case highlights the diagnostic challenges of malignant hyperthermia during cardiac surgery with cardiopulmonary bypass."

Cardiovascular • Metabolic Disorders

Delayed Presentation of Malignant Hyperthermia in a Patient Undergoing Craniotomy for Tumor Resection (ASA 2026) - "Patient was induced with propofol, remifentanil, lidocaine, and rocuronium. Maintenance anesthesia was carried out with sevoflurane and remifentanil...Patient was given dantrolene and active cooling measures were initiated. Surgery was aborted, however patient successfully underwent tumor resection weeks later with MH precautions. Presentation of MH can vary widely and requires hypervigilance of anesthesiologist to recognize this disorder at any time during the perioperative period."

Clinical • Brain Cancer • Oncology • Solid Tumor

An Insidious Crisis: Delayed Malignant Hyperthermia in an Unidentified Neuroendovasular Patient (ASA 2026) - "She underwent induction with succinylcholine and received maintenance sevoflurane. She was treated with dantrolene sodium with improvement and was transferred to the ICU intubated. This case highlights diagnostic and management challenges of malignant hyperthermia, specifically in patients with insidious presentations, unknown histories, and potentially confounding surgical factors (such as embolization and anticoagulation)."

Clinical • Cardiovascular • Hypertension • Metabolic Disorders • Subarachnoid Hemorrhage

Atypical Presentation of Malignant Hyperthermia Without Volatile Agent Exposure (ASA 2026) - "Despite no volatile administration, residual circuit exposure was suspected as the primary trigger and succinylcholine as a secondary stimulus. Dantrolene led to rapid improvement, emphasizing the importance of recognition and management of MH."

Bipolar Disorder • Cardiovascular • CNS Disorders • Coronary Artery Disease • Genetic Disorders • Hypertension • Mood Disorders • RYR1

Preventive measures against the risk of malignant hyperthermia in a young Venezuelan woman with Aymé-Gripp syndrome. (ASA 2026) - "Procedure ended without complications. This case highlights the rigorous preparation required to address the risk of malignant hyperthermia in pediatric patients, without ruling out the possibility that dantrolene may not be available in some low-income hospitals"

Clinical • Musculoskeletal Diseases

RECURRENT MALIGNANT HYPERTHERMIA IN A 2-MONTH OLD (ASA 2026) - "Initially stabilized after an intraoperative MH event requiring dantrolene, the patient later exhibited tachycardia, hypercarbia, metabolic acidosis, and hyperthermia during sedation weaning in the NICU...The course was complicated by hyperkalemia, arrhythmias, and elevated creatine kinase. This case highlights atypical, non-anesthetic-triggered MH recurrence and underscores need for heightened vigilance and prolonged therapy."

Cardiovascular • Infectious Disease • Metabolic Disorders • Septic Shock • RYR1

Delayed-Onset Malignant Hyperthermia Following General Anesthesia: A Case Report (ASA 2026) - "We report a case of delayed-onset MH in a 59-year-old female following percutaneous nephrostomy tube placement under general anesthesia with sevoflurane. MH was suspected, and dantrolene was promptly administered with rapid clinical improvement. This case highlights the potential for delayed MH presentation and underscores the importance of maintaining clinical suspicion beyond the immediate perioperative period."

Case report • Clinical

Empiric Malignant Hyperthermia Treatment in Severe Postoperative Rhabdomyolysis Following Prolonged Thyroidectomy (ASA 2026) - "Propofol was discontinued and empiric dantrolene was initiated. He developed metabolic acidosis requiring bicarbonate infusion with subsequent renal recovery and CK normalization. This case highlights early empiric treatment of suspected malignant hyperthermia in postoperative hypermetabolic syndromes with diagnostic uncertainty."

Cardiovascular • Chronic Kidney Disease • Genetic Disorders • Hypertension • Hypotension • Metabolic Disorders • Obesity • Solid Tumor • Thyroid Gland Carcinoma • Thyroid Gland Papillary Carcinoma

The Induction That Triggered a Crisis: Malignant Hyperthermia in a 9-Year-Old (ASA 2026) - "Prompt administration of dantrolene, discontinuation of triggering agent, active cooling, and supportive measures were implemented. Creatine kinase peaked at 90,000 U/L with transient rhabdomyolysis and transaminitis. This case underscores the importance of vigilance during every anesthetic induction and readiness to initiate malignant hyperthermia protocols in pediatric patients."

Cardiovascular

Navigating the Heat: Malignant Hyperthermia During Living Donor Liver Transplantation (ASA 2026) - "A 61-year-old male with MASH-cirrhosis c/b portal-HTN, EV, and HE underwent living-donor liver-transplantation under isoflurane anesthesia...Prior exposure to sevoflurane and succinylcholine was uneventful. Volatile anesthetic was discontinued, TIVA initiated, and dantrolene administered, with rapid improvement. Postoperative genetic testing identified a pathogenic RYR1 variant. This case highlights diagnostic recognition and management of MH in a physiologically-constrained transplant setting."

Hepatology • Immunology • Metabolic Disorders • Metabolic Dysfunction-Associated Steatohepatitis • Transplantation

Malignant Hyperthermia in a 52-Year-Old with Osteogenesis Imperfecta (ASA 2026) - "Following administration of sevoflurane, succinylcholine, and subsequent endotracheal intubation, he developed pulseless electrical activity, followed by hyperthermia, hypercarbia, and hemodynamic instability. Malignant hyperthermia was suspected; dantrolene was administered, and anesthesia converted to total intravenous anesthesia with rapid stabilization. Differential diagnoses included allergic reaction and other hypermetabolic syndromes. This case highlights diagnostic challenges and the importance of early MH recognition and treatment in patients with complex perioperative risk factors."

Genetic Disorders • Metabolic Disorders

Fulminant Hyperthermia After Liver Transplantation: When Occam's Razor Fails (ASA 2026) - "A 50-year-old male underwent orthotopic liver transplantation under general anesthesia with sevoflurane...Malignant hyperthermia was suspected (Larach score: 43), and dantrolene was administered, resulting in significant temperature reduction and hemodynamic improvement. Maintenance therapy was withheld due to rising transaminases. The patient progressed to acute liver failure and died within 48 hours, underscoring the need to consider concurrent diagnoses."

Cardiovascular • Hepatology • Liver Failure • Metabolic Disorders • Transplant Rejection • Transplantation • Ventricular Tachycardia

When the Fever Breaks: Severe Hyperpyrexia Without Muscle Rigidity in the ICU (ASA 2026) - "Given the severity, empiric dantrolene was administered, resulting in rapid defervescence...He subsequently failed ventilator weaning, requiring tracheostomy after one month. He was later decannulated and discharged to short-term rehabilitation following recovery."

Cardiovascular • Chronic Obstructive Pulmonary Disease • CNS Disorders • Immunology • Infectious Disease • Pneumonia • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases • Schizophrenia

SPE21. Mock Malignant Hyperthermia Hotline Call (1 CME) (ASA 2026) - "The audience will observe the consultant's calm and reassuring demeanor while effectively guiding vital patient safety decisions. SessionLearningObjective1: List the first three steps to manage an MH Crisis.SessionLearningObjective2: Differentiate different presentations of Malignant Hyperthermia.SessionLearningObjective3: List the steps of emergent Dantrolene administration."

Molecular regulatory mechanism of TRPV4-mediated calcium-dependent 5-HT secretion from enterochromaffin cells and its involvement in ulcerative colitis. (PubMed, PLoS One) - "Carbachol (CCh), a stable analog of ACh, activated mAChR/IP3/IP3R pathway to increase intracellular [Ca2+]ilevels in ECs, in which both TRPV4 channels and RyR were activated in response to CCh...In addition, selective blocker of RyR (Dantrolene) also significantly inhibited CCh-induced calcium signals and membrane currents...Taken together, this study reveals a novel mAChR/IP3/IP3R /TRPV4/5-HT pathway in ECs is likely involved in the pathogenesis of UC. Targeting this pathway holds a promise for the potential prevention and treatment of UC."

Journal • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Bowel Disease • Ulcerative Colitis

Use of extracorporeal cardiopulmonary resuscitation in malignant hyperthermia-induced sudden cardiac arrest - A case study. (PubMed, Saudi J Anaesth) - "The patient was transferred to the emergency department of a tertiary care university hospital, where dantrolene treatment was initiated and the patient was qualified for extracorporeal cardiopulmonary resuscitation. Despite several hours of intensive care, the patient died."

Journal • Anesthesia • Cardiovascular • Critical care

The ubiquitin-activating enzyme inhibitor TAK-243 activates store-operated Ca2+ channels independently of endoplasmic reticulum Ca2+ stores and enhances mitochondrial Ca2+ buffering capacity in DU-145 human prostate cancer cells. (PubMed, Biochim Biophys Acta Mol Cell Res) - "Live-cell Ca2+ imaging with Fura2 showed that DU-145 cells exhibited spontaneous Ca2+ transients that were largely independent of the activity of the Na+/Ca2+ exchanger but were abolished by extracellular Ca2+ removal, La3+, Gd3+, BTP2 (Orai channel blocker), and thapsigargin (which depletes endoplasmic reticulum -ER- Ca2+ stores). They were also sensitive to U73122 (a phospholipase C inhibitor) and dantrolene (a ryanodine receptor blocker), suggesting the contribution of both store-operated Ca2+ channels and intracellular Ca2+ release pathways in the generation and maintenance of these Ca2+ spikes...TAK-243 also increased the membrane potential and the Ca2+ buffering capacities of mitochondria. Taken together, treating DU-145 cells with TAK-243 to prevent the ubiquitination of proteins activates the entry of Ca2+ through store-operated Ca2+ channels independently of the ER Ca2+ stores and alters mitochondrial functions."

Journal • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor • Targeted Protein Degradation • STIM1

Malignant Hyperthermia Crisis During a Laparoscopic Appendectomy: A Case Report. (PubMed, S D Med) - "This is the case of 53-year-old man who had a MH crisis after exposure to the volatile anesthetic sevoflurane. He recovered without significant long-term complications. This case contributes to the literature highlighting the early recognition and use of dantrolene for successful treatment in MH crises along with help from the MH hotline."

Journal • Anesthesia • Cardiovascular

Cooperative roles of W882 and W996 in state-dependent dantrolene stabilization within the RyR1 P1 domain. (PubMed, J Mol Graph Model) - "Alanine substitution of these residues increased ligand conformational flexibility and substantially reduced the energetic barriers associated with ligand dissociation, whereas R1000 exhibited comparatively smaller contributions to overall binding stability. Overall, these computational findings are consistent with previous experimental observations and provide atomistic insight into the interaction networks and structural determinants underlying state-dependent stabilization of dantrolene in a cryo-EM-derived RyR1 P1-domain binding model."

Journal • RYR1