Cardiac troponin I is increased in patients admitted to the emergency department with severe allergic reactions. A case–control study

Lippi, Giuseppe; Buonocore, Ruggero; Schirosa, Fabio; Cervellin, Gianfranco

doi:10.1016/j.ijcard.2015.05.093

Cited by 41 publications

(30 citation statements)

References 10 publications

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“…In the recent important study [16], of 31 patients admitted to the emergency department and suffering from anaphylaxis, angioedema, urticaria and urticariaangioedema it was found these patients had significantly increased troponin I serum levels in comparison with 125 healthy controls. In the subgroup of anaphylaxis, troponin I levels were higher than those of patients with milder allergic reactions.…”

Section: Incidence and Epidemiologymentioning

confidence: 98%

“…Finally, in 2015, Lippi and his colleagues [16] found that in patients who were admitted to the emergency department and suffering from anaphylaxis, angioedema, urticaria and urticaria-angioedema, the troponin I levels, that are specific for diagnosing acute myocardial injury, are significantly increased in comparison with healthy controls. This denotes that the heart and especially the coronary arteries constitute primary targets in anaphylaxis.…”

Section: Historical Backgroundmentioning

confidence: 99%

“…Cardiac enzymes such as CK and in particular CK-MB are of value in diagnosing cardiac damage associated with allergic or anaphylactic insults. The systematic measurement of cardiac troponins in all patients admitted to the emergency department with acute allergic reactions in order to timely diagnose and appropriately manage a potential cardiac injury manifesting as Kounis syndrome [16] or as takotsubo cardiomyopathy [54] has been already suggested. Echocardiography and coronary angiography are necessary in diagnosing cardiac wall abnormalities including takotsubo cardiomyopathy and delineating the coronary anatomy in cases of Kounis syndrome.…”

Section: Diagnosismentioning

confidence: 99%

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Kounis syndrome: an update on epidemiology, pathogenesis, diagnosis and therapeutic management

Kounis¹

2016

Clinical Chemistry and Laboratory Medicine (CCLM)

312

421

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Kounis syndrome has been established as a hypersensitivity coronary disorder induced by various conditions, drugs, environmental exposures, foods and coronary stents. Allergic, hypersensitivity, anaphylactic and anaphylactoid reactions are associated with this syndrome. Vasospastic allergic angina, allergic myocardial infarction and stent thrombosis with occluding thrombus infiltrated by eosinophils and/or mast cells constitute are the three reported, so far, variants of this syndrome. Apart from coronary arteries, it affects the cerebral and mesenteric arteries. Its manifestations are broadening and its etiology is continuously increasing. Kounis syndrome is a ubiquitous disease which represents a magnificent natural paradigm and nature's own experiment in a final trigger pathway implicated in cases of coronary artery spasm and plaque rupture. Kounis syndrome seems to be not a rare disease but an infrequently diagnosed clinical entity which has revealed that the same mediators released from the same inflammatory cells are also present and in acute coronary events of non allergic etiology. These cells are not only present in the culprit region before plaque erosion or rupture but they release their contents just before an actual coronary event. Therefore, awareness of etiology, epidemiology, pathogenesis and clinical manifestations seems to be important for its prognosis, diagnosis, treatment, prevention.

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Section: Incidence and Epidemiologymentioning

confidence: 98%

Section: Historical Backgroundmentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

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Kounis syndrome: an update on epidemiology, pathogenesis, diagnosis and therapeutic management

Kounis¹

2016

Clinical Chemistry and Laboratory Medicine (CCLM)

312

421

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“…A variety of electrocardiographic changes ranging from ST segment elevation or depression to heart block (any degree) and cardiac arrhythmias indicating digoxin toxicity are always associated with the cardiac symptoms [7]. The mediators released induce myocardial injury, resulting in increased troponin levels [7][8][9]. Echocardiography and coronary angiography show absolutely normal coronary arteries with no luminal irregularities, thus excluding myocardial infraction [7].…”

mentioning

confidence: 99%

Kounis Syndrome: Is it Really a Takotsubo-Like Syndrome?

Kotsiou

Xirogiannis

Gourgoulianis

2017

J Investig Allergol Clin Immunol

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“…Systematic troponin measurement in patients with acute allergic reactions is advisable in order to detect and treat potential myocardiac injury. [8] Finally, in 300 anaphylaxis cases, myocardial injury was present in 7.3% of patients. Various cardiomyopathies, including Kounis syndrome and Takotsubo cardiomyopathy, were also observed in patients with myocardial injury.…”

mentioning

confidence: 99%