Dying before the system caught up: a case of neurofibromatosis type 1 in a geriatric patient with pain and polypharmacy

Abstract We present the case of a 72-year-old man with a history of neurofibromatosis type 1 (NF1) who experienced chronic pain, hypotension, and progressive functional decline. His complex medication regimen posed daily management challenges and may have contributed to fluctuations in blood pressure and impaired mobility, which may have impacted his overall clinical stability. This case provides a rare opportunity to examine NF1 in the context of advanced age, a perspective not often explored in case literature as the disease is typically diagnosed and studied in pediatric populations. It illustrates how common geriatric challenges such as polypharmacy, loss of independence, caregiver reliance, and refractory pain can be further complicated by the lifelong burden of a rare genetic condition. Additionally, this case highlights the lack of specific guidelines addressing pain secondary to NF1, and explores the various types of pain associated with the condition.