scaly lesions on the edges and palmar aspects of the hands, greyish discolouration of the ear pinna and stiff and hard helical cartilage were noted in our patient can easily be missed.[ 6 ] Calcifications in the coronaries, cardiac valves and aortic root, urinary pigment calculi and nephrotoxicity may be significant enough to alter anaesthetic management.[ 2 ] Although surgical implications are minimal, surgeons should involve the anaesthesiologist, physician and cardiologist early in the pre-operative period to establish a well-planned management approach.
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