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June 27, 1986

Serum Creatine Kinase Screening for Susceptibility to Malignant Hyperthermia

JAMA. 1986;255(24):3363. doi:10.1001/jama.1986.03370240033019

To the Editor.—  In the Feb 14 issue, Paasuke and Brownell1 reported that serum creatine kinase levels routinely determined before muscle biopsy for caffeine contracture testing for susceptibility to malignant hyperthermia (MH) had no diagnostic value. Creatine kinase values were uniformly within the normal range unless the patient had a diagnosed clinical myopathy.I wish to report a different result. While I was associated with the University of Texas Medical Branch, Galveston, my colleague, T. E. Nelson, and I established a diagnostic laboratory offering halothane-caffeine contracture testing for MH susceptibility .2 A review of my records indicates that 113 patients had determination of their creatine kinase level prior to biopsy. The results are shown in the Table.My experience disagrees with that of Paasuke and Brownell. Patients who are MH susceptible frequently have an elevated serum creatine kinase level before biopsy. A serum creatine kinase screen of the MH