Anesthesia Management in an NF1 Patient with Type 1 Diabetes: A Case Report
| Author | Seyed Alireza Seyed Siamdoust | en |
| Author | Behrooz Zaman | en |
| Author | Taymaz Amiraslani | en |
| Author | Samad Noorizad | en |
| Author | Selda Zahedi | en |
| Author | Mohammad Reza Akhoondinasab | en |
| Orcid | Seyed Alireza Seyed Siamdoust [0000-0002-4739-0101] | en |
| Orcid | Behrooz Zaman [0000-0002-2059-3697] | en |
| Orcid | Taymaz Amiraslani [0000-0002-5304-9540] | en |
| Orcid | Samad Noorizad [0000-0002-8384-7279] | en |
| Issued Date | 2026-06-30 | en |
| Abstract | Introduction: The co-occurrence of neurofibromatosis type 1 (NF1) and type 1 diabetes mellitus (T1DM) in a surgical patient presents a rare, high-stakes anesthetic challenge. NF1 is associated with potentially difficult airways, vasculopathies, and catecholamine-secreting tumors, whereas T1DM requires meticulous perioperative glycemic control. Following a systematic literature search in PubMed and Scopus, we found no specific combined guideline for this dual diagnosis. This report aims to clarify the critical interactions between these disorders and propose an evidence-informed framework. Case Presentation: A 42-year-old woman (ASA III) with confirmed NF1 and T1DM presented for recurrent surgical debridement. Her NF1 phenotype included substantial posterior neck muscle hypertrophy; a thick neck with a neck circumference of 58 cm; pronounced neck stiffness with a sternomental distance of 6 cm; Mallampati class III airway anatomy suggestive of macroglossia; inability of the lower incisors to bite the upper lip; and adequate mouth opening, with an inter-incisor distance of 4.5 cm measured between the upper and lower incisors during maximal mouth opening. A significant history of intraoperative hypoglycemia during previous procedures was noted. Conclusions: This single-case observation suggests that successful perioperative management may depend on a proactive, protocol-driven strategy. Key elements include a primary airway plan that avoids paralysis, strict adherence to T1DM glucose protocols, and an anesthetic technique that prioritizes cardiovascular stability. This hypothesis-generating report provides a preliminary framework for clinical contexts in which standardized guidelines are lacking. | en |
| DOI | https://doi.org/10.5812/jcma-171715 | en |
| URI | https://brieflands.com/journals/jcma/articles/171715 | en |
| Keyword | Neurofibromatosis Type 1 | en |
| Keyword | Type 1 Diabetes Mellitus | en |
| Keyword | Difficult Airway | en |
| Keyword | Supraglottic Airway Device | en |
| Keyword | Perioperative Glycemic Control | en |
| Publisher | Brieflands | en |
| Title | Anesthesia Management in an NF1 Patient with Type 1 Diabetes: A Case Report | en |
| Type | Case Report | en |