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CRITICAL CARE AND TRAUMA

Fechtner’s Syndrome: Considerations of Anesthetic Management

Fritz Mertzlufft, MD, PhD^*, Andreas Koster, MD^§, Helmut Steinhart, MD, PhD, Joachim F. Schenk, MD, and George J. Crystal, PhD^¶

Departments of *Anesthesiology and Intensive Care, ENT Surgery, and Clinical Hemostaseology and Transfusion Medicine, Universitaetskliniken des Saarlandes, Homburg/Saar; §Department of Anesthesiology, Deutsches Herzzentrum Berlin, Berlin, Germany; and ¶Department of Anesthesiology, Illinois Masonic Medical Center and Departments of Anesthesiology and of Physiology and Biophysics, University of Illinois College of Medicine, Chicago, Illinois

Address correspondence and reprint requests to Prof. Dr. med. Fritz Mertzlufft, Klinik fuer Anaesthesiologie und Intensivmedizin, Universitaetskliniken des Saarlandes, D-66421 Homburg/Saar, Germany. Address e-mail to mertzlufft{at}t-online.de

Implications: Fechtner’s syndrome is a rare form of macrothrombocytopenia (potentially associated with other hemostatic deficiencies, e.g., von Willebrand’s disease and protein Z deficiency), which can exacerbate the risk of uncontrollable bleeding during surgery. We describe the management of a patient with Fechtner’s syndrome involving desmopressin, prednisone, and platelets, which produced safe and effective results during cochlear implant surgery.