Kounis syndrome caused by double allergens: the more allergens present, the easier, the quicker, and the more severe the anaphylaxis

Kounis, Nicholas G.; Koniari, Ioanna; Plotas, Panagiotis; Soufras, George D.; Tsigkas, Grigorios; Davlouros, Periklis; Hahalis, George

doi:10.1097/cm9.0000000000000946

Cited by 2 publications

(4 citation statements)

References 9 publications

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“…В данном случае предшествующая острому ИМ системная анафилактическая реакция у пациента с факторами риска ИБС (отягощенная наследственность, мужской пол, возраст, АГ, курение, сахарный диабет и дислипидемия) позволяет предположить у него синдром Коуниса II типа [1]. Дискутабельным остается вопрос о причине разрыва атеросклеротической бляшки и тромбоза коронарной артерии (КА): являлось ли это событие прямым следствием вазоспазма и/или выброса медиаторов воспаления на фоне аллергической реакции или же вызвано экзогенным введением адреналина, который по данным литературы может выступать самостоятельным триггером для развития ИМ [6].…”

Section: Discussionunclassified

Kounis Syndrome: Myocardial Infarction After Wasp Bites

Resnyanskaya,

Evdokimov,

Feoktistova

2024

Arhivʺ vnutrennej mediciny

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The presented clinical case describes a rather rare type II Kunis syndrome (SC) that occurred in a 69-year-old man with risk factors for coronary heart disease (CHD) after wasp bites and was accompanied by the development of acute myocardial infarction (MI) due to coronary artery thrombosis (CA). The diagnosis of MI was confirmed on the basis of laboratory and instrumental data: an increase in troponin levels (>10000 pg/ml), changes in the electrocardiogram (ECG) (elevation of the ST segment in II, III leads, aVF), revealed violations of the contractility of the left ventricle (LV) according to echocardiography (zone of akinesia of the basal lower segment LV, hypokinesia of the median inferior and anterolateral segments of the LV, the apical-lateral segment of the LV), the results of coronary angiography (acute occlusion with signs of parietal thrombosis in the right coronary artery). The cause of CA thrombosis could be either a pronounced immuno-inflammatory reaction or the administration of adrenaline to stop anaphylactic reaction. Currently, there are no clear criteria for the verification of SC, the diagnosis is confirmed on the basis of a comprehensive examination of a patient with acute coronary syndrome (ACS) and the presence of a pronounced allergic/anaphylactic reaction. Additionally, to confirm the SC, it is proposed to assess the level of histamine and tryptase in the blood, however, these markers are metabolized quite quickly and, in most cases, it is not possible to identify their elevated levels. This case once again underlines the importance of informing doctors about the risk of developing ACS against the background of a pronounced allergic reaction, as well as the need for further study of SC in order to develop tactics for the treatment and prevention of this group of patients.

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Section: Discussionunclassified

Kounis Syndrome: Myocardial Infarction After Wasp Bites

Resnyanskaya,

Evdokimov,

Feoktistova

2024

Arhivʺ vnutrennej mediciny

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“…[ 5 ] Once the patients are exposed to corresponding allergens, the effector cells will be triggered and then release its mediator, leading to an allergic inflammation. [ 5 ] Allergen immunotherapy based on specific allergens to patients is considered a promising and effective treatment for allergic diseases. [ 6 , 7 ] Therefore, identification of the IgE-binding allergens will improve the diagnosis of allergy diseases and application of immunotherapy.…”

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confidence: 99%

“…Immunoglobulin E (IgE) antibodies play a key role in allergy diseases. They are synthesized and released by B cells and bind to high-affinity IgE receptors on mast cells or basophils [5] . Once the patients are exposed to corresponding allergens, the effector cells will be triggered and then release its mediator, leading to an allergic inflammation [5] .…”

mentioning

confidence: 99%

“…They are synthesized and released by B cells and bind to high-affinity IgE receptors on mast cells or basophils [5] . Once the patients are exposed to corresponding allergens, the effector cells will be triggered and then release its mediator, leading to an allergic inflammation [5] . Allergen immunotherapy based on specific allergens to patients is considered a promising and effective treatment for allergic diseases [6,7] .…”

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confidence: 99%

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Cloning, expression, and immunological characterization of two novel profilins from Artemisia annua

Zhu

et al. 2020

Chinese Medical Journal

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Kounis syndrome caused by double allergens: the more allergens present, the easier, the quicker, and the more severe the anaphylaxis

Cited by 2 publications

References 9 publications

Kounis Syndrome: Myocardial Infarction After Wasp Bites

Kounis Syndrome: Myocardial Infarction After Wasp Bites

Cloning, expression, and immunological characterization of two novel profilins from Artemisia annua

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