| Anesthetic management of a parturient with carnitine palmitoyltransferase II deficiency. | |
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MedLine Citation:
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PMID: 16636033 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To report the anesthetic management of a patient with carnitine palmitoyltransferase II deficiency who presented for labour and delivery. CLINICAL FEATURES: A 30-yr-old primiparous woman with known carnitine palmitoyltransferase II deficiency and a past history of exercise induced muscle pain, weakness and myoglobinuria presented in active labour. Management consisted of an early epidural for labour and continuous dextrose infusion with frequent blood sugar monitoring. She had an uneventful spontaneous vaginal delivery. She experienced a single asymptomatic episode of hypoglycemia on the first postpartum day. Her serum creatine kinase was six times normal at 24 hr post-delivery and remained elevated for three days without evidence of rhabdomyolysis. The remainder of her postpartum course was uneventful. CONCLUSION: Labour and delivery is a potential precipitant of rhabdomyolysis in patients with carnitine palmitoyltransferase II deficiency. The normal postpartum creatine kinase elevation (two to four times baseline at 24 hr) must be taken into account when monitoring these patients. On the basis of the physiologic principles, institution of early epidural analgesia to blunt the stress response to labour and delivery, continuous dextrose infusion and frequent glucose monitoring during labour and postpartum are the mainstays of management. |
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Authors:
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Suzanne Lilker; Shilpa Kasodekar; Eric Goldszmidt |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Canadian journal of anaesthesia = Journal canadien d'anesthésie Volume: 53 ISSN: 0832-610X ISO Abbreviation: Can J Anaesth Publication Date: 2006 May |
Date Detail:
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Created Date: 2006-04-25 Completed Date: 2006-10-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8701709 Medline TA: Can J Anaesth Country: Canada |
Other Details:
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Languages: eng Pagination: 482-6 Citation Subset: IM |
Affiliation:
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Department of Anesthesia and Pain, Mount Sinai Hospital, University of Toronto, Ontario M5G 1X5, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Analgesia, Epidural Anesthesia, Epidural Anesthesia, Obstetrical* Blood Glucose / analysis Carnitine O-Palmitoyltransferase / deficiency* Creatine Kinase / blood Female Follow-Up Studies Glucose / therapeutic use Humans Hypoglycemia / etiology Hypoglycemic Agents / therapeutic use Labor, Obstetric / physiology Metabolism, Inborn Errors / complications*, physiopathology Pregnancy Pregnancy Complications / physiopathology* Rhabdomyolysis / prevention & control |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 0/Hypoglycemic Agents; 50-99-7/Glucose; EC 2.3.1.21/Carnitine O-Palmitoyltransferase; EC 2.7.3.2/Creatine Kinase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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