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Intraoperative adrenal insufficiency in a patient with prader-willi syndrome
David W Barbara1, James D Hannon, William R Hartman
1Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Abstract:
Prader-Willi syndrome (PW) is a rare genetic disorder with multi-organ system involvement. These patients present many perioperative challenges including sleep-related breathing disorders, morbid obesity, thick salivary secretions, mental retardation, and difficult intravenous access. PW has been suggested to be associated with central adrenal insufficiency. We report a novel case of persistent severe hypotension from previously undiagnosed and asymptomatic adrenal insufficiency in a pediatric patient with Prader-Willi syndrome during spine surgery that resolved upon treatment with hydrocortisone.
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