# Anesthesia for Urgent Gastroscopy in Cold Agglutinin Disease: A Case Report and Literature Review

## TL;DR

This case report discusses the safe use of anesthesia during an urgent gastroscopy for a patient with cold agglutinin disease, a rare condition worsened by cold exposure.

## Contribution

The paper presents a novel anesthetic approach tailored to prevent complications in patients with cold agglutinin disease undergoing emergency procedures.

## Key findings

- Sedation with midazolam and propofol was safely administered while avoiding hypothermia.
- High-flow nasal cannulae helped maintain oxygenation during the procedure.
- The described technique offers a reference for managing similar cases in the future.

## Abstract

We present the case of a 76-year-old lady who underwent an emergency gastroscopy for suspected upper gastrointestinal bleeding on a background of cold agglutinin disease, a rare autoimmune haemolytic anaemia triggered by cold temperatures. Several pre-operative and intra-operative precautions were taken to minimise the risk of hypothermia. Sedation anaesthesia was used with midazolam and gradual titration of propofol with high-flow nasal cannulae to maintain oxygenation. The anaesthetic proceeded safely and without complications, and we compared our technique to the literature.