Expert: Ronald Levy, M.D. - 10/22/2009

Question
My sister has MH.  She was diagnosed during the removal of her tonsils when she was about 24, she's 42 now.

I would like to know if you have ever heard of a MH person or relative reacting to an asthma inhalers.

My son has had some very odd reactions to differate medications in the past, most recently, to two different asthma inhalers, one with albuterol and one without.  

He reacts to it with extreme muscle cramping, but his temperature remains constant.  He is extemely weak the next day.  When we had him examined the first time he reacted, they tested his blood and urine and saw no indicators, those were taken about 3 hours after his pain/cramping started (would that be enough time to register an elevated muscle cell count in his urine?).  It just reminds me so much of my sister's reaction (less the fever, and the elevated muscle cells in her urine)and how it weaken her for about two weeks after her episode.  It's happened 3 times now, and it leaves him unable to walk for 2 days.

He takes adderall for ADHD, which I understand can cause the central nervous system to go haywired also, but none of the doctors that have seen him, have ever heard of such a bad reaction.

I know it is a long shot, however it is a rare allegy, and not much is know about it, just wondering if an expert has ever heard of this strange overreaction, MH related or not.

Answer
I have not heard of a cross reactivity with the two but since MH is so rare, I do not have that much experience with it. My suggestion would be to contact MHAUS (Malignant Hyperthermia Association of the United States) at (607) 674-7901. They are the experts in this and will have the most up-to-date information. It is also a good site for you and your family members to check out and register at (http://www.mhaus.org/).

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston