Malignant Hyperthermia in the Absence of Triggering Agents

To the Editor Upon review of Table 1 in the recent review by Larach et al.1 summarizing the presentation, treatment, and complications related to malignant hyperthermia, I was concerned to see a reference to a patient with a family history of malignant hyperthermia who developed an episode despite the absence of what we would ordinarily consider to be the usual triggering agents (succinylcholine or a volatile agent).Table 1: Results of the 2 GroupsI would welcome further elaboration by the authors as to their speculated mechanism for the development of malignant hyperthermia in this patient. Nancy Setzer-Saade, MD Department of Anesthesiology, Perioperative and Pain Medicine University of Miami Miami, Florida [email protected] or [email protected]