Anesthetic Considerations in an Infant With Malan Syndrome: A Case Report

Malan syndrome, also known as Sotos-like syndrome or Sotos syndrome 2, is an overgrowth disorder that results from point mutations of the nuclear factor I/X (NFIX) gene. The phenotype consists of macrocephaly, facial dysmorphisms, hypotonia, and developmental delay. While case reports in the anesthesiology literature regarding the care of patients with Sotos syndrome do not identify significant anesthetic problems, more knowledge concerning the care of patients with Malan syndrome is necessary. Anesthesia providers must be aware of this clinical phenotype and prepare for possible difficult intravenous access and difficult airway management.