Evidence map›Paper›PMID 40952511›Full record

ArticleJournal of anesthesia2026

Postoperative malignant hyperthermia in a one-year-old girl with down syndrome: a case report.

Ryosuke Sato, Shintaro Kishimoto, Momoko Oyake, Saori Oguri, Tomoyo Itonaga, Yoshihide Kuribayashi, Yoshifumi Ohchi, Keiko Mukaida, Kenji Ihara

Abstract readCase Reports
PubMed Publisher
In one paragraph

Article in Journal of anesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Letter to the article by Sato et al.Journal of anesthesia · 2025
    Article
  2. Reply to the letter by Triwiyanto.Journal of anesthesia · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ryosuke SatoDepartment of Pediatrics, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan.
Shintaro KishimotoDepartment of Pediatrics, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan. skishimoto0131@oita-u.ac.jp.ORCID http://orcid.org/0009-0006-5239-0540
Momoko OyakeDepartment of Pediatrics, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan.
Saori OguriDepartment of Pediatrics, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan.
Tomoyo ItonagaDepartment of Pediatrics, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan.
Yoshihide KuribayashiDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, Oita University, Oita, Japan.
Yoshifumi OhchiDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, Oita University, Oita, Japan.
Keiko MukaidaDepartment of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan.
Kenji IharaDepartment of Pediatrics, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Malignant hyperthermia (MH) is a severe complication of general anesthesia, characterized by myotonia, muscle rigidity, acidosis, hyperthermia, tachycardia, and hyperpnea. Herein, we report the case of a 1-year-old girl with congenital heart disease (CHD) and Down syndrome (DS) who underwent cheiloplasty. Approximately 50 min after the completion of general anesthesia, she presented with tachycardia, hyperpnea, and fever, notably without any muscle-related symptoms. Initially, a respiratory infection was suspected, prompting antibiotic administration. However, by postoperative day 2, her symptoms persisted and were accompanied by elevated creatine kinase (CK) and transaminase levels. These findings led us to consider acute heart failure (AHF) secondary to CHD as a potential cause of her symptoms, but her condition did not improve despite cardiac intervention. By postoperative day 6, a markedly elevated plasma myoglobin level suggested the occurrence of MH, even without muscle symptoms. Administration of dantrolene led to the rapid resolution of her symptoms. Genetic testing subsequently confirmed that she had developed postoperative MH. This case highlights the difficulty in diagnosing MH in children with DS associated with CHD.

Indexed as

Anesthesia, GeneralDown SyndromeMalignant HyperthermiaPostoperative ComplicationsDantroleneFemaleHeart Defects, CongenitalHumansInfantDantroleneChildrenCongenital heart diseaseDown syndromeMalignant hyperthermiaPostoperative

Identifiers

PMID40952511

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.