Delayed Kounis syndrome and acute renal failure after wasp sting

Jairam, Anantharam; Kumar, Rajesh; Ak, Ghosh; Hasija, P.K.; Singh, Jai Inder; Mahapatra, Debasish; Bairaria, A.K.S.

doi:10.1016/j.ijcard.2008.06.004

Cited by 11 publications

(11 citation statements)

References 7 publications

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“…18 As a result, this case may have presented as a 'delayed Kounis syndrome', of which two cases have been described in the literature. 19,20 The cytokine profile of this case is complicated by cardiac arrest as well as the fact that the patient was cooled with therapeutic hypothermia and rewarmed, a phenomenon known to influence cytokine profiles. 21,22 Interleukin (IL)-6 levels have been demonstrated to be elevated in therapeutic hypothermia following cardiac arrest, explaining the elevated level of IL-6 in our case.…”

Section: Discussionmentioning

confidence: 99%

Capecitabine-induced ventricular fibrillation arrest: Possible Kounis syndrome

Kido

Adams

Morehead

et al. 2015

J Oncol Pharm Pract

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We report the case of capecitabine-induced ventricular fibrillation arrest, possibly secondary to type I Kounis syndrome. A 47-year-old man with a history of T3N1 moderately differentiated adenocarcinoma of the colon, status-post sigmoid resection, was started on adjuvant capecitabine approximately five months prior to presentation of cardiac arrest secondary to ventricular fibrillation. An electrocardiogram (EKG) revealed ST segment elevation on the lateral leads and the patient was taken emergently to the cardiac catheterization laboratory. The catheterization revealed no angiographically significant stenosis and coronary artery disease was ruled out. After ruling out other causes of cardiac arrest, the working diagnosis was capecitabine-induced ventricular fibrillation arrest. As such, an inflammatory work up was sent to evaluate for the possibility of a capecitabine hypersensitivity, or Kounis syndrome, and is the first documented report in the literature to do so when evaluating Kounis syndrome. Immunoglobulin E (IgE), tryptase, and C-reactive protein were normal but histamine, interleukin (IL)-6, and IL-10 were elevated. Histamine elevation supports the suspicion that our patient had type I Kounis syndrome. Naranjo adverse drug reaction probability scale indicates a probable adverse effect due to capecitabine with seven points. A case of capecitabine-induced ventricular fibrillation arrest is reported, with a potential for type 1 Kounis syndrome as an underlying pathology supported by immunologic work up.

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Section: Discussionmentioning

confidence: 99%

Capecitabine-induced ventricular fibrillation arrest: Possible Kounis syndrome

Kido

Adams

Morehead

et al. 2015

J Oncol Pharm Pract

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“…Thus, these catecholamines probably played a role in the developmentof TTC. TTC has been reported after a wasp bites (16) a jellyfish sting (17), as well as following a snake bites (18). It is uncertain, in these previous reports, whether the toxin given by these creatures directly injured the myocardium (19).…”

Section: Discussionmentioning

confidence: 99%

Severe Tetanus Complicated by Takotsubo Cardiomyopathy

Araki¹,

Iwanami²,

Yamazaki³

2019

Intern. Med.

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A 70-year-old woman was admitted to our hospital due to difficulty in moving her limbs. She had trismus and a necrotic and contaminated wound in her left lower leg. A diagnosis of tetanus was confirmed and intensive care was started. On the second day, her blood pressure fell and a ST segment elevation on electrocardiography (ECG) was detected. She was diagnosed with takotsubo cardiomyopathy by echocardiogram and improved undergoing conservative therapy.

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“…2 The most unusual manifestations of hymenoptera venom allergy include Kounis syndrome with or without takotsubo or octopus pot heart cardiomyopathy. 2,3 The risk factors for significant allergic reactions to Hymenoptera venom have been identified as multiple prior stings in predisposed beekeepers and gardeners, previous allergic reactions to Hymenoptera stings, elevated baseline serum tryptase levels (410 ng/mL), mastocytosis, and antihypertensive therapy with angiotensin-converting enzyme inhibitors and possibly β-blockers. 2 In the case presented, the patient exhibited 2 of these risk factors for Hymenoptera venom allergy: prior Hymenoptera stings as an outdoor gardener, and known allergy to honeybee (order Hymenoptera, family Apidae) venom.…”

Section: Discussionmentioning

confidence: 99%

A Wasp Sting and a Broken Heart

Diaz

2016

Wilderness & Environmental Medicine

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Delayed Kounis syndrome and acute renal failure after wasp sting

Cited by 11 publications

References 7 publications

Capecitabine-induced ventricular fibrillation arrest: Possible Kounis syndrome

Capecitabine-induced ventricular fibrillation arrest: Possible Kounis syndrome

Severe Tetanus Complicated by Takotsubo Cardiomyopathy

A Wasp Sting and a Broken Heart

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