A Journal of the University of Malta Medical School
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Case Report
Acute coronary syndrome in diclofenac sodium-induced type I hypersensitivity reaction: Kounis syndrome
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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