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British Journal of Anaesthesia, 2001, Vol. 87, No. 2 240-245
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Homozygous and heterozygous Arg614Cys mutations (1840C->T) in the ryanodine receptor gene co-segregate with malignant hyperthermia susceptibility in a German family

H. Rueffert1, D. Olthoff1, C. Deutrich1, B. Thamm1 and U. G. Froster2

1Department of Anaesthesiology and Intensive Care Medicine, University of Leipzig, Liebigstr. 20a, D-04103 Leipzig, Germany. 2Institute for Human Genetics, University of Leipzig, Philipp-Rosenthal-Str. 55, D-04103 Leipzig, Germany*Corresponding author

The determination of susceptibility to malignant hyperthermia (MH) by genetic investigation is a controversial issue because of the genetic heterogeneity of this disorder. The requirement for such an approach in MH diagnosis is a strong correlation between MH-associated genetic abnormalities and phenotypic findings in the in vitro contracture test (IVCT). After a severe clinical MH crisis during general anaesthesia a patient was diagnosed by the IVCT in which susceptibility to MH was confirmed. Genetic screening for MH-related mutations in the RYR1 gene revealed the presence of a homozygous 1840C->T base exchange (Arg614Cys substitution) in this patient. A specific search for this defect in 20 relatives led to the identification of a total of 11 Arg614Cys mutations. Of these, 10 were heterozygous (including both parents) and one was homozygous (sister). Further IVCTs were subsequently performed on the parents of the index patient, the homozygous sister and all relatives who did not carry the Arg614Cys in order to determine the genotype/phenotype correlation. After analysing these data, and because of the strong correlation between clinical, phenotypic, and genetic results in the index patient, we assigned the diagnosis ‘MHS’ to all the remaining Arg614Cys mutation carriers of that family without performing the IVCT.

Br J Anaesth 2001; 87: 240–5


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