Abstract
Introduction
The coincidental occurrence of a cardiac symptomatology (e.g. an acute coronary syndrome
or a myocardial infarction), during an anaphylactic or anaphylactoid episode is known
as Kounis Syndrome. A variety of drugs, substances, food and environmental exposures
are associated with this reaction. There is an exponential increase in the number
of published scientific articles reports on this syndrome, but since it is rare, the
largest case series published so far included only 10 and 6 patients.
Methods
We searched the global World Health Organization database called VigiBase™ to detect
all cases of Kounis Syndrome ever reported (last update December 31st 2014).
Results
We identified 51 cases of Kounis Syndrome reported to International Pharmacovigilance
Agency (VigiBase™). All these cases were reported in the period 2010–2014 and almost
half cases (22 reports) belonged to the year 2014. Most cases occurred in the USA
and non-steroidal anti-inflammatory drugs were the most frequent trigger drugs.
Discussion
We collected pharmacovigilance international data representing the largest case series
ever published on the recently identified Kounis Syndrome.
Keywords
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References
- Acute myocardial infarction during a prolonged allergic reaction to penicillin.Am. Heart J. 1950; 40: 945-947
- Contribution to the problem of allergic etiology of angina pectoris and myocardial infarct.Klin. Med. Osterr. Z. Wiss. Prakt. Med. 1950; 5: 364-367
- Histamine-induced coronary artery spasm: the concept of allergic angina.Br. J. Clin. Pract. 1991; 45: 121-128
- A case of Kounis syndrome presented with sudden cardiac death.Anadolu Kardiyol Derg. 2012; 12: 599-600
- Coronary artery spasm associated with eosinophilia: another manifestation of Kounis syndrome?.Heart Lung Circ. 2009; 18: 163-164
- Mechanisms of coronary artery spasm.Circulation. 2011; 124: 1774-1782
- Infiltrates of activated mast cells at the site of coronary atheromatous erosion or rupture in myocardial infarction.Circulation. 1995; 92: 1083-1088
- Drug eluting stent-induced Kounis syndrome.Int. J. Cardiol. 2011; 146: e16-e98
- Kounis syndrome uncovers critical left main coronary disease: the question of administering epinephrine.Int. J. Cardiol. 2012; 157: e43-e45
- International consensus on (ICON) anaphylaxis.World Allergy Organ J. 2014; 7: 9
- World Allergy Organization Anaphylaxis Guidelines: 2013 update of the evidence base.. 2013; 162: 193-204
- Treatment of Kounis syndrome.Int. J. Cardiol. 2010; 143: 223-226
- Coronary hypersensitivity disorder: the Kounis syndrome.Clin. Ther. 2013; 35: 563-571
- Kounis Syndrome: a stinging case of ST-elevation myocardial infarction.Heart Lung Circ. 2015; 24: e48-e50
- Acute stent thrombosis due to Kounis syndrome.Int. J. Cardiol. 2014; 177: 698-700
- Drugeluting stent thrombosis: the Kounis hypersensitivity-associated acute coronary syndrome revisited.JACC Cardiovasc. Interv. 2009; 2: 583-593
- Insect sting anaphylaxis; prospective evaluation of treatment with intravenous adrenaline and volume resuscitation.Emerg. Med. J. 2004; 21: 149-154
- Introductory guide MedDRA Version 15.1, Geneva: The International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH).(Available at)
- Kounis syndrome: first series in Turkish patients.Anadolu Kardiyol Derg. 2009; 9: 59-60
- Underdiagnosis and pharmacovigilance. The case of allergic acute coronary syndrome (Kounis syndrome).Int. J. Cardiol. 2013; 168: 5054-5055
- Kounis syndrome: report of 5 cases.J. Investig. Allergol. Clin. Immunol. 2010; 20: 162-165
- Mast cell-related disorders presenting with Kounis syndrome.Int. J. Cardiol. 2012; 161: 56-58
- Kounis syndrome.Med. Intensiva. 2012; 36: 358-364
- Takotsubo cardiomyopathy, mental stress and the Kounis syndrome.Int. J. Card. 2012; 161: 65-67
- Takotsubo and Kounis syndrome: is there any association?.Circulation J. 2007; 71: 170
- Tako-Tsubo cardiomyopathy or Kounis syndrome: finding differences and similarities to answer the question.Intern. Emerg. Med. 2013; 8: 637-638
- Kounis syndrome associated with brain injury after Hymenoptera sting: new presentation of an established entity.Int. J. Cardiol. 2014; 176: e29-e31
- Brain injury due to anaphylactic shock: broadening manifestations of Kounis syndrome.Int. Endod. J. 2014; 47: 309-313
- Chronic atherosclerotic mesenteric ischemia that started to develop symptoms just after anaphylaxis.Case Rep. Gastroenterol. 2012; 6: 300-308
Article info
Publication history
Published online: October 13, 2015
Accepted:
October 3,
2015
Received in revised form:
September 22,
2015
Received:
July 27,
2015
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
