What is the difference between Malignant Hyperthermia (MH) and Transverse Myelitis Association (TMA)?

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Last updated: March 19, 2025View editorial policy

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From the Guidelines

Malignant Hyperthermia (MH) and Transverse Myelitis Association (TMA) are two distinct medical conditions with different pathophysiologies and clinical manifestations. The key difference between the two conditions is that MH is a life-threatening medical emergency triggered by certain anesthetics, characterized by an uncontrollable rise in body temperature, muscle rigidity, and metabolic acidosis, as described in the 2021 guideline from the Association of Anaesthetists 1. On the other hand, TMA is a broader term that refers to a range of conditions affecting the spinal cord, including transverse myelitis, which is an inflammatory condition that damages the spinal cord, leading to symptoms such as weakness, numbness, and bladder dysfunction.

Some key features of MH include:

  • Increased heart rate and blood pressure
  • Increased oxygen consumption and carbon dioxide production
  • Muscle contractile activity and heat generation
  • Acidosis, hyperkalaemia, and arrhythmias
  • Disseminated intravascular coagulopathy and massive rhabdomyolysis

In contrast, TMA is a condition that affects the spinal cord, and its diagnosis and treatment require specialized care, as noted in the 2023 commentary on the management of glomerular diseases 1. The evaluation and treatment of TMA are highly specialized and may require specific testing and treatment with plasma exchange, which may not be widely available.

It is essential to recognize the differences between MH and TMA to ensure proper diagnosis and management of patients presenting with these conditions, as delayed or incorrect diagnosis can lead to significant morbidity and mortality. Therefore, it is crucial to prioritize the diagnosis and treatment of MH and TMA based on their distinct clinical features and pathophysiologies.

From the Research

Definition and Characteristics of Malignant Hyperthermia (MH) and Transverse Myelitis Association (TMA)

  • Malignant Hyperthermia (MH) is not defined in the provided studies.
  • Transverse Myelitis Association (TMA) is actually referred to as Thrombotic Microangiopathy (TMA) in the studies, which is a heterogeneous collection of syndromes characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ injury 2, 3, 4, 5, 6.

Differences between MH and TMA

  • There is no information available in the provided studies to compare or differentiate between Malignant Hyperthermia (MH) and Transverse Myelitis Association (TMA), as MH is not mentioned in the studies.
  • The studies focus on Thrombotic Microangiopathy (TMA), its clinical characteristics, diagnosis, and management, highlighting the complexity and diversity of TMA-causing conditions 3, 4, 5, 6.

Clinical Characteristics and Management of TMA

  • TMA is characterized by microangiopathic hemolytic anemia, consumptive thrombocytopenia, and organ injury stemming from endothelial damage and vascular occlusion 3.
  • The management of TMA involves determining the underlying cause, as treatment strategies differ, and may include therapeutic plasma exchange, immunosuppression, and complement inhibition 2, 3, 4, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Clinical Evaluation and Management of Thrombotic Microangiopathy.

Arthritis & rheumatology (Hoboken, N.J.), 2024

Research

Thrombotic microangiopathy and indications for therapeutic plasma exchange.

Hematology. American Society of Hematology. Education Program, 2014

Research

Use of Eculizumab in Thrombotic Microangiopathy Associated with Hematopoietic Stem Cell Transplantation.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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