自己免疫疾患を合併したKlinefelter症候群患者に対する全身麻酔経験

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We experienced a case of ambulatory anesthesia for a 13-year-old boy with 47XXY Klinefelter's syndrome and systemic lupus erythematosus. He visited the Department of Pediatric Dentistry in our hospital complaining of toothache. He underwent dental treatment under general anesthesia.The previous year, he had visited the Department of Pediatrics because of fever, and thrombocytopenia was found. A detailed examination was therefore performed and revealed that his chromosomal type is 47XXY. Additionally, he was diagnosed with systemic lupus erythematosus, since he had antinuclear antibody, anti-DNA ds antibody, anti-sm antibody, and PA IgG. He took prednisolone 5mg every day. In the preoperative examination, the platelet count was 12.8 × 104/micro-L. PT-INR was 1.32 and APTT was 57.5 seconds. Hemorrhagic diathesis, however, was not observed clearly.Anesthesia was induced with intravenous midazolam and fentanyl and maintained with inhalation of sevoflurane and intravenous fentanyl. No severe complication occurred.A patient with Klinefelter's syndrome is often complicated with autoimmune diseases, so it is important to pay attention to the patient's condition.
日本口腔診断学会の論文