Síndrome de Kounis tipo I

Immunoglobulin E–Mediated Severe Allergy to Hyoscine Butylbromide

“…Diagnosis is based on symptoms and suggestive signs of an acute allergic reaction simultaneously with acute coronary syndrome (angina, vegetative symptoms) related to previous contact with a possible allergen [4,5]. The patient we report, who had no coronary risk factors, had presented 2 episodes of epigastric pain with bilious vomiting during the previous 6 months.…”

“…It is thought that following an allergic stimulus, inflammatory mediators are released by mast cells, leading to spastic contraction of coronary smooth muscle cells [2,3]. Three types of KS have been described [4], as follows: type I, coronary vasospasm without significant coronary disease; type II, patients with pre-existing coronary disease in which the release of pro-inflammatory mediators (histamine, leukotrienes and serotonin) can cause vasospasm or instability of atherosclerotic plaques; and type III, in which drugeluting stent thrombosis is associated with a hypersensitivity reaction [5]. Although several drugs (antibiotics, nonsteroidal anti-inflammatory drugs, anticoagulants, corticosteroids, anesthetics, and contrast media) have been associated with KS, antibiotics are the most frequently involved [6,7].…”