Cargando…

The more allergens an atopic patient is exposed to, the easier and quicker anaphylactic shock and Kounis syndrome appear: Clinical and therapeutic paradoxes

Kounis syndrome is a condition that combines allergic, hypersensitivity, anaphylactic or anaphylactoid reactions with acute coronary syndromes including vasospastic angina, acute myocardial infarction and stent thrombosis. This syndrome is a ubiquitous disease affecting patients of any age, involvin...

Descripción completa

Detalles Bibliográficos
Autores principales: Kounis, N. G., Mazarakis, A., Almpanis, G., Gkouias, K., Kounis, G. N., Tsigkas, G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4121890/
https://www.ncbi.nlm.nih.gov/pubmed/25097390
http://dx.doi.org/10.4103/0976-9668.136145
_version_ 1782329271516135424
author Kounis, N. G.
Mazarakis, A.
Almpanis, G.
Gkouias, K.
Kounis, G. N.
Tsigkas, G.
author_facet Kounis, N. G.
Mazarakis, A.
Almpanis, G.
Gkouias, K.
Kounis, G. N.
Tsigkas, G.
author_sort Kounis, N. G.
collection PubMed
description Kounis syndrome is a condition that combines allergic, hypersensitivity, anaphylactic or anaphylactoid reactions with acute coronary syndromes including vasospastic angina, acute myocardial infarction and stent thrombosis. This syndrome is a ubiquitous disease affecting patients of any age, involving numerous and continuously increasing causes, with broadening clinical manifestations and covering a wide spectrum of mast cell activation disorders. Drugs, environmental exposures and various conditions are the main offenders. Clinical and therapeutic paradoxes concerning Kounis syndrome therapy, pathophysiology, clinical course and causality have been encountered during its clinical course. Drugs that counteract allergy, such as H2-antihistamines, can induce allergy and Kounis syndrome. The more drugs an atopic patient is exposed to, the easier and quicker anaphylaxis and Kounis syndrome can occur. Every anesthetized patient is under the risk of multiple drugs and substances that can induce anaphylactic reaction and Kounis syndrome. The heart and the coronary arteries seem to be the primary target in severe anaphylaxis manifesting as Kounis syndrome. Commercially available adrenaline saves lives in anaphylaxis but it contains as preservative sodium metabisulfite and should be avoided in the sulfite allergic patients. Thus, careful patient past history and consideration for drug side effects and allergy should be taken into account before use. The decision to prescribe a drug where there is a history of previous adverse reactions requires careful assessment of the risks and potential benefits.
format Online
Article
Text
id pubmed-4121890
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-41218902014-08-05 The more allergens an atopic patient is exposed to, the easier and quicker anaphylactic shock and Kounis syndrome appear: Clinical and therapeutic paradoxes Kounis, N. G. Mazarakis, A. Almpanis, G. Gkouias, K. Kounis, G. N. Tsigkas, G. J Nat Sci Biol Med Original Article Kounis syndrome is a condition that combines allergic, hypersensitivity, anaphylactic or anaphylactoid reactions with acute coronary syndromes including vasospastic angina, acute myocardial infarction and stent thrombosis. This syndrome is a ubiquitous disease affecting patients of any age, involving numerous and continuously increasing causes, with broadening clinical manifestations and covering a wide spectrum of mast cell activation disorders. Drugs, environmental exposures and various conditions are the main offenders. Clinical and therapeutic paradoxes concerning Kounis syndrome therapy, pathophysiology, clinical course and causality have been encountered during its clinical course. Drugs that counteract allergy, such as H2-antihistamines, can induce allergy and Kounis syndrome. The more drugs an atopic patient is exposed to, the easier and quicker anaphylaxis and Kounis syndrome can occur. Every anesthetized patient is under the risk of multiple drugs and substances that can induce anaphylactic reaction and Kounis syndrome. The heart and the coronary arteries seem to be the primary target in severe anaphylaxis manifesting as Kounis syndrome. Commercially available adrenaline saves lives in anaphylaxis but it contains as preservative sodium metabisulfite and should be avoided in the sulfite allergic patients. Thus, careful patient past history and consideration for drug side effects and allergy should be taken into account before use. The decision to prescribe a drug where there is a history of previous adverse reactions requires careful assessment of the risks and potential benefits. Medknow Publications & Media Pvt Ltd 2014 /pmc/articles/PMC4121890/ /pubmed/25097390 http://dx.doi.org/10.4103/0976-9668.136145 Text en Copyright: © Journal of Natural Science, Biology and Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kounis, N. G.
Mazarakis, A.
Almpanis, G.
Gkouias, K.
Kounis, G. N.
Tsigkas, G.
The more allergens an atopic patient is exposed to, the easier and quicker anaphylactic shock and Kounis syndrome appear: Clinical and therapeutic paradoxes
title The more allergens an atopic patient is exposed to, the easier and quicker anaphylactic shock and Kounis syndrome appear: Clinical and therapeutic paradoxes
title_full The more allergens an atopic patient is exposed to, the easier and quicker anaphylactic shock and Kounis syndrome appear: Clinical and therapeutic paradoxes
title_fullStr The more allergens an atopic patient is exposed to, the easier and quicker anaphylactic shock and Kounis syndrome appear: Clinical and therapeutic paradoxes
title_full_unstemmed The more allergens an atopic patient is exposed to, the easier and quicker anaphylactic shock and Kounis syndrome appear: Clinical and therapeutic paradoxes
title_short The more allergens an atopic patient is exposed to, the easier and quicker anaphylactic shock and Kounis syndrome appear: Clinical and therapeutic paradoxes
title_sort more allergens an atopic patient is exposed to, the easier and quicker anaphylactic shock and kounis syndrome appear: clinical and therapeutic paradoxes
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4121890/
https://www.ncbi.nlm.nih.gov/pubmed/25097390
http://dx.doi.org/10.4103/0976-9668.136145
work_keys_str_mv AT kounisng themoreallergensanatopicpatientisexposedtotheeasierandquickeranaphylacticshockandkounissyndromeappearclinicalandtherapeuticparadoxes
AT mazarakisa themoreallergensanatopicpatientisexposedtotheeasierandquickeranaphylacticshockandkounissyndromeappearclinicalandtherapeuticparadoxes
AT almpanisg themoreallergensanatopicpatientisexposedtotheeasierandquickeranaphylacticshockandkounissyndromeappearclinicalandtherapeuticparadoxes
AT gkouiask themoreallergensanatopicpatientisexposedtotheeasierandquickeranaphylacticshockandkounissyndromeappearclinicalandtherapeuticparadoxes
AT kounisgn themoreallergensanatopicpatientisexposedtotheeasierandquickeranaphylacticshockandkounissyndromeappearclinicalandtherapeuticparadoxes
AT tsigkasg themoreallergensanatopicpatientisexposedtotheeasierandquickeranaphylacticshockandkounissyndromeappearclinicalandtherapeuticparadoxes
AT kounisng moreallergensanatopicpatientisexposedtotheeasierandquickeranaphylacticshockandkounissyndromeappearclinicalandtherapeuticparadoxes
AT mazarakisa moreallergensanatopicpatientisexposedtotheeasierandquickeranaphylacticshockandkounissyndromeappearclinicalandtherapeuticparadoxes
AT almpanisg moreallergensanatopicpatientisexposedtotheeasierandquickeranaphylacticshockandkounissyndromeappearclinicalandtherapeuticparadoxes
AT gkouiask moreallergensanatopicpatientisexposedtotheeasierandquickeranaphylacticshockandkounissyndromeappearclinicalandtherapeuticparadoxes
AT kounisgn moreallergensanatopicpatientisexposedtotheeasierandquickeranaphylacticshockandkounissyndromeappearclinicalandtherapeuticparadoxes
AT tsigkasg moreallergensanatopicpatientisexposedtotheeasierandquickeranaphylacticshockandkounissyndromeappearclinicalandtherapeuticparadoxes