Undiagnosed scleroderma in a patient with a difficult airway.

Connective tissue disorders occur because of autoimmune-influenced destruction or synthesis of any of the components that are found in these tissues. Systemic involvement of multiple organs is common. Patients are often chronically ill and treated with corticosteroids. Scleroderma or progressive systemic scletosis (PSS) is a generalized disorder of connective tissue characterized by degenerative and inflammatory changes that subsequently leads to intense fibrosis [1]. Due to systemic involvement, patients with scleroderma can pose a challenge to the anesthesiologist. In this case report, we describe a patient with an unrecognized difficult airway associated with undiagnosed scleroderma. This disease process not only contributed to our difficulty in visualization of the larynx but also impeded other maneuvers to secure the airway.