Wolfram syndrome. How much could knowledge challenge the fate? A case report.
BACKGROUND
Wolfram syndrome (WS) is a rare, autosomic recessive genetic disorder. The mortality rate of WS is about 65% before 35 years of age. It presents diagnostic challenges in the clinical practice due to its incomplete characterization. This report represents the first case of undiagnosed Wolfram syndrome in a patient over 53 years old.


METHODS
A 53-year-old white woman developed a respiratory complication necessitating extended ICU care and respiratory rehabilitation. This respiratory complication proved to be a consequence of undiagnosed WS.


CONCLUSIONS
The report discusses the clinical elements that suggested the diagnosis, the problems related to the ICU management of this patient, in particular the weaning difficulties, and the need for rehabilitation. Finally, the report considers the ethical aspect of timely diagnosis on the course and outcome of WS.
Department of Medical and Surgical Critical Care, Section of Anesthesia and Intensive Care, Florence University, Florence, Italy. chiarabecchi@hotmail.com
Lea Paola
LP
Fabbri
Maria
M
Nucera
Antonello
A
Grippo
Adriana
A
Menicucci
Maria Laura
ML
De Feo
Chiara
C
Becchi
Mohamed
M
Al Malyan
D005260:Female; D006801:Humans; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology*; D012131:Respiratory Insufficiency / Q000209:etiology*; D014929:Wolfram Syndrome / Q000150:complications / Q000175:diagnosis* / Q000235:genetics