General anesthetic

• McArdle disease may increase the risk of a malignant hyperthermia-type of reaction to anesthetic agents [1].

• Rhabdomyolysis, acute renal failure and electrolyte abnormalities may ensue.

• Although a very small risk, it is advisable to inform the anesthetist of the risk prior to any surgery. Choice of low risk agents and careful monitoring can further lower the risk.

[1] McArdle’s disease and anaesthesia: case reports. Review of potential problems and association with malignant hyperthermia. Bollig G, Mohr S, and Raeder J (2005) Acta Anaesthesiol Scand 49: 1077-1083.

Tourniquets

• People with McArdle disease are at increased risk of developing compartment syndrome through use of tourniquets [1].

• Prior to surgery, advise the surgeon of the risk.

• Limit length of use of blood pressure cuffs.

[1] Acute compartment syndrome after forearm ischemic work test in a patient with McArdle’s disease. Lindner A, Reichert N, Eichhorn M, and Zierz S (2001) Neurology 56: , 1779-1780.

Examinations

• Patients may be at risk of cramping when holding an awkward position for examination or treatment.