Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 110
Filtrar
1.
Praxis (Bern 1994) ; 113(5): 134-137, 2024 May.
Artigo em Alemão | MEDLINE | ID: mdl-38864101

RESUMO

INTRODUCTION: We describe the case of a 58-year-old patient who developed chest pain and an anaphylaktoide reaction after ingestion of contamined fish containing histamin. Histamin intoxication from food poisoning (also known as scombroid intoxication) can be mistaken for an anaphylactic reaction and occasionaly lead to cardiac symptoms, even in patients without atherosclerotic changes. This condition is called Kounis syndrom and has to be recognized as a separate syndrom with specific clinical features.


Assuntos
Dor no Peito , Eletrocardiografia , Humanos , Pessoa de Meia-Idade , Dor no Peito/etiologia , Diagnóstico Diferencial , Masculino , Síndrome de Kounis/diagnóstico , Síndrome de Kounis/etiologia , Animais , Anafilaxia/induzido quimicamente , Anafilaxia/diagnóstico , Doenças Transmitidas por Alimentos/diagnóstico , Doenças Transmitidas por Alimentos/etiologia , Toxinas Marinhas/intoxicação
5.
Rev Esp Anestesiol Reanim (Engl Ed) ; 71(2): 129-133, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37683977

RESUMO

Kounis syndrome is defined as cardiovascular symptoms that occur secondary to allergic or hypersensitivity insults, and is also called allergic angina and allergic myocardial infarction. We report a case of pre-operative ceftriaxone-induced Kounis syndrome with no evident dermatological manifestation, and describe our diagnostic dilemma. The patient was symptomatically managed and discharged in stable condition with a warning against future use of ceftriaxone.


Assuntos
Síndrome de Kounis , Doenças Vasculares , Humanos , Síndrome de Kounis/etiologia , Síndrome de Kounis/diagnóstico , Ceftriaxona/efeitos adversos , Doenças Vasculares/complicações
8.
BMJ Case Rep ; 16(10)2023 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-37879707

RESUMO

Kounis syndrome is a rare type of acute coronary syndrome (ACS) that occurs as a result of an allergic or anaphylactic reaction. Kounis syndrome can be induced by various medications including antibiotics, proton pump inhibitors, antihypertensive medications, corticosteroids, and antineoplastic medications. Additionally, cases of Kounis syndrome associated with lansoprazole and pantoprazole have been previously reported in the literature. In this report, we present a case of Kounis syndrome associated with omeprazole use, and discuss the need for a high index of suspicion as it is often underrecognised.


Assuntos
Anafilaxia , Síndrome de Kounis , Humanos , Anafilaxia/induzido quimicamente , Anafilaxia/diagnóstico , Síndrome de Kounis/etiologia , Síndrome de Kounis/complicações , Omeprazol/efeitos adversos , Inibidores da Bomba de Prótons/efeitos adversos
10.
Rev Med Liege ; 78(7-8): 399-402, 2023 Jul.
Artigo em Francês | MEDLINE | ID: mdl-37560948

RESUMO

Although not well known, Kounis syndrome represents 3.4 % of anaphylactic reactions and has a high level of mortality (7 %). Its main clinical presentation looks like an acute coronary syndrome. We report the case of a 61-year old patient who was admitted in the emergency department because of a malaise with loss of consciousness due to a Kounis syndrome that occurred after the ingestion of amoxycilline.


Le syndrome de Kounis représente une entité mal connue, bien que présent dans 3,4 % des réactions anaphylactiques avec une mortalité élevée de 7 %. Ses manifestations sont des symptômes mimant un syndrome coronarien aigu. Nous présentons ici le cas d'un patient de 61 ans admis au service des urgences pour un malaise avec perte de connaissance attribué à un syndrome de Kounis survenu dans les suites de la prise d'amoxycilline.


Assuntos
Síndrome Coronariana Aguda , Anafilaxia , Síndrome de Kounis , Humanos , Pessoa de Meia-Idade , Anafilaxia/diagnóstico , Anafilaxia/etiologia , Síndrome de Kounis/etiologia , Síndrome de Kounis/complicações , Síndrome Coronariana Aguda/induzido quimicamente , Síndrome Coronariana Aguda/diagnóstico , Serviço Hospitalar de Emergência , Hospitalização
11.
Medicine (Baltimore) ; 102(32): e34535, 2023 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-37565887

RESUMO

RATIONALE: Kounis syndrome is a rare but life-threatening anaphylactic reaction that can lead to acute coronary syndrome and cardiac arrest, and requires prompt diagnosis. Adrenaline, which is used to treat anaphylaxis, may cause coronary vasoconstriction and worsen ischemia, whereas coronary vasodilators may dilate systemic vessels and exacerbate hypotension. Delayed diagnosis of Kounis syndrome and inadequate therapeutic intervention may thus lead to a poor outcome. PATIENT CONCERNS: A 59-year-old man was treated for sepsis due to a liver abscess. Following administration of daptomycin, the patient developed severe anaphylactic shock leading to refractory cardiac arrest. Because conventional cardiopulmonary resuscitation was ineffective, extracorporeal cardiopulmonary resuscitation was considered as an alternative approach. DIAGNOSES: On bedside monitoring during cardiopulmonary resuscitation, unexpected ST-segment elevation was found on lead II electrocardiogram. Accordingly, the patient was clinically diagnosed with Kounis syndrome. INTERVENTIONS: Nicorandil (6 mg/h), a coronary vasodilator with minimal blood pressure effects, was administered along with high doses of vasopressors, including adrenaline 0.2 µg/kg/min. OUTCOMES: After the initiation of nicorandil administration, the patient achieved return of spontaneous circulation and did not require extracorporeal cardiopulmonary resuscitation. Based on the elevated serum tryptase level, normal creatine kinase-MB range, and lack of stenosis on coronary angiography, the patient was definitively diagnosed with type I (coronary vasospasm) Kounis syndrome. He was subsequently transferred to the referring hospital without neurological sequelae. LESSONS: If anaphylaxis leads to refractory shock and cardiac arrest, ischemic changes on the electrocardiogram should be investigated to identify underlying Kounis syndrome. In addition to adrenaline, coronary dilators are the definitive treatment. Nicorandil may be a useful treatment option because of its minimal effect on blood pressure.


Assuntos
Anafilaxia , Vasoespasmo Coronário , Parada Cardíaca , Síndrome de Kounis , Masculino , Humanos , Pessoa de Meia-Idade , Epinefrina/efeitos adversos , Nicorandil/efeitos adversos , Anafilaxia/induzido quimicamente , Anafilaxia/tratamento farmacológico , Anafilaxia/complicações , Síndrome de Kounis/tratamento farmacológico , Síndrome de Kounis/etiologia , Síndrome de Kounis/diagnóstico , Parada Cardíaca/induzido quimicamente , Parada Cardíaca/terapia , Vasodilatadores/uso terapêutico , Vasoespasmo Coronário/induzido quimicamente , Vasoespasmo Coronário/tratamento farmacológico , Vasoespasmo Coronário/complicações
13.
Immunol Allergy Clin North Am ; 43(3): 503-512, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37394256

RESUMO

Acute coronary syndrome (ACS) in the setting of an allergic/immunologic reaction is known as Kounis syndrome. It is an underdiagnosed and underrecognized disease entity. One must keep a high index of suspicions when managing a patient presenting with cardiac as well as allergic symptoms. There are 3 main variants to the syndrome. Treating the allergic reaction may alleviate the pain; however, ACS guidelines should be followed if cardiac ischemia is present.


Assuntos
Síndrome Coronariana Aguda , Hipersensibilidade , Síndrome de Kounis , Humanos , Síndrome de Kounis/diagnóstico , Síndrome de Kounis/etiologia , Síndrome de Kounis/terapia , Síndrome Coronariana Aguda/diagnóstico , Síndrome Coronariana Aguda/etiologia , Síndrome Coronariana Aguda/terapia
14.
Cardiol Rev ; 31(4): 230-232, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37335982

RESUMO

Kounis syndrome is a hypersensitivity disorder secondary to allergy or anaphylaxis that can result in acute coronary syndrome. Kounis syndrome has an increasing prevalence since its first identification in 1950. Divided into 3 subtypes, each with diagnostic criteria, the management of Kounis syndrome presents a clinical challenge. We aim to identify the pathophysiological mechanisms and review the diagnosis, epidemiology, management strategies, and future directions of Kounis syndrome. As Kounis syndrome becomes more widely recognized in the medical community, the role of diagnosis, treatment, and future immunomodulatory prevention strategies will continue to unfold.


Assuntos
Síndrome Coronariana Aguda , Anafilaxia , Síndrome de Kounis , Humanos , Síndrome de Kounis/diagnóstico , Síndrome de Kounis/etiologia , Síndrome Coronariana Aguda/diagnóstico , Síndrome Coronariana Aguda/etiologia , Anafilaxia/complicações
15.
J Med Case Rep ; 17(1): 289, 2023 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-37370178

RESUMO

INTRODUCTION AND IMPORTANCE: Kounis syndrome, also known as allergic angina syndrome, is defined as the occurrence of an acute coronary syndrome concomitantly with a hypersensitivity reaction. It is a very important diagnosis and missing it may be fatal to the patient. This is a medical emergency, and immediate treatment should be initiated. The treatment of Kounis syndrome is challenging because treatment of either acute coronary syndrome and hypersensitivity reaction can lead to the worsening of the other injury. This case is the first reported case of Kounis syndrome following coronavirus disease 2019 vaccination in Sri Lanka according to our knowledge. CASE PRESENTATION: We discuss a 54-year-old female Sri Lankan patient who developed Kounis syndrome following Oxford AstraZeneca COVID-19 vaccination. The patient initially developed anaphylaxis following the AstraZeneca COVID-19 vaccine and subsequently developed acute coronary syndrome secondary to anaphylaxis. The patient was treated appropriately and eventually recovered from her condition. CONCLUSION: This syndrome should be suspected when there is a concurrent acute coronary syndrome with allergic reactions. This is an often under- or misdiagnosed condition, and physicians should be educated about it. Caregivers should be aware of its pathophysiology, as treatment of either of the two may worsen the other injury.


Assuntos
Síndrome Coronariana Aguda , Anafilaxia , Vacinas contra COVID-19 , COVID-19 , Síndrome de Kounis , Feminino , Humanos , Pessoa de Meia-Idade , Síndrome Coronariana Aguda/etiologia , Anafilaxia/induzido quimicamente , COVID-19/complicações , Vacinas contra COVID-19/efeitos adversos , Síndrome de Kounis/diagnóstico , Síndrome de Kounis/etiologia
16.
A A Pract ; 17(3): e01672, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36940363

RESUMO

Postinduction hypotension, though frequently due to anesthetic medications, has a variety of causes. We present a case of presumed intraoperative Kounis syndrome, or anaphylaxis-induced coronary vasospasm, in which the patient's perioperative course was initially attributed to anesthesia-induced hypotension and iatrogenic rebound hypertension leading to Takotsubo cardiomyopathy. A second anesthetic event with immediate recurrence of hypotension after the patient received levetiracetam appears to confirm the diagnosis of Kounis syndrome. In this report, we discuss the fixation error that led to this patient's original misdiagnosis.


Assuntos
Anafilaxia , Vasoespasmo Coronário , Hipotensão , Síndrome de Kounis , Humanos , Síndrome de Kounis/diagnóstico , Síndrome de Kounis/etiologia , Anafilaxia/induzido quimicamente , Vasoespasmo Coronário/induzido quimicamente , Vasoespasmo Coronário/diagnóstico , Hipotensão/induzido quimicamente , Hipotensão/complicações
17.
Am J Emerg Med ; 67: 197.e3-197.e5, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36959053

RESUMO

Kounis Syndrome is an acute coronary syndrome in the setting of mast cell activation. Mast cell activation can be due to anaphylaxis, anaphylactoid reaction, allergies, or hypersensitivities. Three reported variants of Kounis Syndrome include: vasospastic allergic angina, allergic myocardial infarction, and stent thrombosis. Herein, we described a case of Type 2 Kounis Syndrome following iodinated contrast infusion for a fistulogram, which manifested as a rare non-ST elevation myocardial infarction (NSTEMI).


Assuntos
Síndrome Coronariana Aguda , Anafilaxia , Síndrome de Kounis , Humanos , Síndrome de Kounis/diagnóstico , Síndrome de Kounis/etiologia , Iohexol , Anafilaxia/induzido quimicamente , Síndrome Coronariana Aguda/diagnóstico por imagem
18.
Tex Heart Inst J ; 50(1)2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-36735919

RESUMO

BACKGROUND: Diclofenac is a widely used analgesic, anti-inflammatory, antipyretic drug. In several case reports, its use was associated with the occurrence of Kounis syndrome. The aim of this review was to investigate and summarize published cases of Kounis syndrome suspected to be associated with the use of diclofenac. METHODS: Electronic searches were conducted in PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, and the Serbian Citation Index. RESULTS: Twenty publications describing the 20 patients who met inclusion criteria were included in the systematic review. Specified patient ages ranged from 34 to 81 years. Eighteen (90.0%) patients were male. Five patients (25.0%) reported a previous reaction to diclofenac. Reported time from the used dose of diclofenac to onset of the first reaction symptoms ranged from immediately to 5 hours. Diclofenac caused both type I and type II Kounis syndrome, with the presence of various cardiovascular, gastrointestinal, dermatologic, and respiratory signs and symptoms. Most patients experienced hypotension (n = 15 [75.0%]) and chest pain (n = 12 [60.0%]). The most frequently reported finding on electrocardiogram was ST-segment elevations (n = 17 [85.0%]). Coronary angiogram showed normal coronary vessels in 9 patients (45.0%), with some pathologic findings in 8 patients (40.0%). CONCLUSION: Clinicians should be aware that Kounis syndrome may be an adverse effect of diclofenac. Prompt recognition and withdrawal of the drug, with treatment of both allergic and cardiac symptoms simultaneously, is important.


Assuntos
Diclofenaco , Síndrome de Kounis , Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Feminino , Diclofenaco/efeitos adversos , Síndrome de Kounis/diagnóstico , Síndrome de Kounis/etiologia , Eletrocardiografia , Angiografia Coronária/efeitos adversos
19.
Tex Heart Inst J ; 50(1)2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-36695737

RESUMO

A 67-year-old woman experienced pruritus, an urticarial rash, and acute, pressure-like chest pain following an insect sting. Initial electrocardiographic findings were notable for ST-segment elevations in the inferior leads without reciprocal changes, but a follow-up electrocardiogram showed pronounced ST-segment elevations in the inferior leads with reciprocal changes. Her troponin I level peaked at 3,053 pg/mL, and she was transferred to a large academic center for percutaneous coronary intervention. Balloon angioplasty was performed for 95% thrombotic occlusion of the mid-right coronary artery, and a drug-eluting stent was placed. The patient's presentation was consistent with type II Kounis syndrome.


Assuntos
Angioplastia Coronária com Balão , Stents Farmacológicos , Síndrome de Kounis , Feminino , Humanos , Idoso , Síndrome de Kounis/diagnóstico , Síndrome de Kounis/etiologia , Síndrome de Kounis/terapia , Coração , Eletrocardiografia
20.
Eur Ann Allergy Clin Immunol ; 55(6): 294-302, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-35850501

RESUMO

Summary: Background. Kounis syndrome (KS) is defined as a rare cause of an acute coronary syndrome associated with systemic allergic reactions. To establish the prevalence of KS among the patients with diagnosis of anaphylaxis, we described clinical features, cardiological and allergological outcomes of patients evaluated in our allergy outpatient clinic. Methods. A retrospective study was carried out in the Allergy Unit of Novara hospital, from January 2008 to March 2020. Skin tests and in vitro tests were performed with suspected etiological agents. Results. We found 9 adults with KS (2%) out of 444 subjects who had experienced anaphylactic reactions (4/9 to Hymenoptera stings, 5/9 to drugs). Conclusions. The present study highlights the importance of suspicion of KS that appears not so uncommon in patients with anaphylaxis. KS seems to be a rare disease because unrecognized in diagnosis of anaphylaxis.


Assuntos
Anafilaxia , Himenópteros , Mordeduras e Picadas de Insetos , Síndrome de Kounis , Adulto , Animais , Humanos , Anafilaxia/diagnóstico , Anafilaxia/epidemiologia , Anafilaxia/etiologia , Síndrome de Kounis/diagnóstico , Síndrome de Kounis/epidemiologia , Síndrome de Kounis/etiologia , Estudos Retrospectivos , Mordeduras e Picadas de Insetos/complicações
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...