Anesthesia Management of a Patient With Familial Cold Autoinflammatory Syndrome: A Case Report

Area of Science:

• Autoinflammatory diseases
• Anesthesiology
• Cryopyrin-associated periodic syndromes (CAPS)

Background:

• Familial cold autoinflammatory syndrome (FCAS) is a rare cryopyrin-associated periodic syndrome (CAPS) characterized by systemic inflammation triggered by cold.
• Patients with FCAS/CAPS require careful management to avoid cold exposure, especially during medical procedures.

Observation:

• A 13-year-old female with FCAS/CAPS undergoing impacted tooth removal presented a perioperative management challenge.
• Perioperative heat loss was a significant concern due to the patient's condition and the surgical setting.

Findings:

• A forced-air warming system was used to prewarm the patient for 10 minutes before general anesthesia induction.
• Core and peripheral temperatures were monitored, showing a minimal difference of 0.4°C within 60 minutes post-prewarming.
• The warming system effectively prevented redistribution hypothermia and FCAS/CAPS symptoms during the perioperative period.

Implications:

• Perioperative forced-air warming is a viable strategy for managing patients with FCAS/CAPS.
• This approach can mitigate the risk of cold-induced inflammatory attacks during surgical procedures.
• Optimized temperature management is crucial for the safety and well-being of patients with rare autoinflammatory disorders.