McLeod Syndrome in a Commercial Airline Pilot

BACKGROUND: The following case report describes the first known case of McLeod Syndrome in a commercial airline pilot. The case describes a 56-yr-old experienced pilot who showed a slow and subtle decline in cognitive function and muscle control in the cockpit. On further examination, the pilot's erratic behavior and movement along with lab abnormalities pointed toward McLeod Syndrome. CASE REPORT: The pilot was recommended for evaluation by his fellow crewmembers due to his fidgetiness, clumsiness, and lack of focus during critical portions of flight. The pilot reported having a long-standing history of elevated CK levels. Further lab investigations revealed acanthocytes on blood smear while neurological evaluation detected chorea. The combination of clinical and laboratory features along with genetic test results were all consistent with McLeod Syndrome. DISCUSSION: The case highlights how subtle behavioral and motor coordination changes can be a warning sign for an underlying progressive neurological disorder that requires further workup and referral.