Information for Medical Professionals
Surgery and Alström Syndrome
Blindness due to retinal degeneration and sensorineural partial hearing loss mean that special preparations are essential to care for patients who are affected by Alström Syndrome undergoing surgery in order to keep them well informed, active preoperatively and able to access prompt rehabilitation post operatively. Other manifestations such as infant and/or adult cardiomyopathy, kyphosis and pulmonary fibrosis are variable in occurrence and severity. This combination of cardio-respiratory changes can predispose to unexpectedly severe hypoxia during episodes of infection or post operatively.
It is necessary to prepare for intensive care following surgery and treat chest infection vigorously. Metabolic disturbances can include hypertriglyceridemia, and insulin resistant diabetes. The severity and responsiveness to treatment of hyperglycaemia is heterogeneous, just as in adult type 2 diabetes as such. A few patients require insulin preoperatively but in many cases blood glucose levels normalise during fasting especially if intravenous glucose is minimised.
In preoperative assessment therefore we would advise:
- ECG and Echocardiogram
- Anaesthetic assessment of airway-kyphosis, small airways and difficult venous access can be troublesome for intubation and cannulation
- Anaerobic threshold bicycle test
- Blood glucose
- Serum triglycerides
- Renal and hepatic function tests