Acute coronary syndrome in diclofenac sodium-induced type I hypersensitivity reaction: Kounis syndrome - Malta Medical Journal Volume 19 (2007); Issue 3 September

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Volume 19, Issue 3 (go to table of contents)

Case Report

Acute coronary syndrome in diclofenac sodium-induced type I hypersensitivity reaction: Kounis syndrome

Zoran M Gluvic, Biljana Putnikovic, Milos Panic, Aleksandra Stojkovic, Zorica Rasic-Milutinovic, Jelena Jankovic-Gavrilovic

Malta Medical Journal, 2007: 3; 36

Drug-induced type I hypersensitivity reactions are frequent. Sometimes, acute coronary syndrome (ACS) can be registered in such patients, which may have a serious impact on the course and management of the allergic reaction. Because of potentially atypical ACS clinical presentations, the ECG is an obligatory diagnostic tool in any allergic reaction. Coronary artery spasm is the pathophysiological basis of ACS, triggered by the action of potent vasoactive mediators (histamine, neutral proteases, arachidonic acid products) released from the cells involved in type I hypersensitivity. Allergic angina and allergic myocardial infarction are referred to as Kounis Syndrome. We describe herein a case of ACS in a patient with registered systemic immediate hypersensitivity reaction which developed following the muscular administration of diclofenac sodium.

Keywords:

Hypersensitivity, anti-inflammatory agents, non-steroidal mast cells, inflammatory mediators, coronary vasospasm

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