Kounis Syndrome

A disorder of cardiac function secondary to hypersensitivity reactions. It is characterized by coexistence of acute coronary syndromes and cardiac MAST CELL and PLATELET ACTIVATION. It may be induced by exposure to drugs (e.g., antibiotics, anesthetics, contrast media), food, and environmental triggers (e.g., insect bites and stings, poison ivy).

Also Known As:

Networked: 384 relevant articles (0 outcomes, 3 trials/studies)

Disease Context: Research Results

Related Diseases

1.	Non-ST Elevated Myocardial Infarction
2.	Hypersensitivity (Allergy)
3.	Thrombosis (Thrombus)
4.	Anaphylaxis (Anaphylactic Shock)
5.	Acute Coronary Syndrome

Experts

1.	Kounis, Nicholas G: 100 articles (09/2022 - 06/2004)
2.	Soufras, George D: 42 articles (08/2021 - 07/2005)
3.	Hahalis, George: 35 articles (07/2020 - 10/2007)
4.	Kounis, George N: 30 articles (04/2016 - 08/2006)
5.	Koniari, Ioanna: 24 articles (09/2022 - 11/2016)
6.	Mazarakis, Andreas: 23 articles (10/2014 - 06/2005)
7.	Tsigkas, Grigorios: 22 articles (09/2022 - 11/2010)
8.	Kounis, N G: 12 articles (03/2021 - 01/2007)
9.	Davlouros, Periklis: 10 articles (07/2020 - 06/2014)
10.	Almpanis, George: 10 articles (10/2014 - 02/2010)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Kounis Syndrome:

1.	Contrast MediaIBA 03/30/2022 - "Iodinated contrast media induced Kounis syndrome during coronary angiogram: a life-threatening clinical dilemma." 02/01/2022 - "Understanding the relationship between contrast agents and Kounis syndrome (KS) is mainly based on case reports. " 02/01/2022 - "Analysis of clinical characteristics of Kounis syndrome induced by contrast media." 09/01/2020 - "Type III Kounis syndrome after administration of an echocardiography contrast agent." 01/01/2020 - "Despite its rarity, physicians and radiologists should be aware of Kounis syndrome triggered by contrast media so it can be rapidly diagnosed and treated.The"
2.	Levofloxacin (Levaquin)FDA Link 01/01/2016 - "Kounis Syndrome After Levofloxacin Intake: A Clinical Report and Cross-reactivity Study." 12/01/2013 - "This is the first case report of Kounis syndrome attributed to levofloxacin administration. " 12/01/2013 - "According to our knowledge, this is the first case report of Kounis syndrome attributed to levofloxacin administration. " 01/01/2017 - "Kounis Syndrome After Intake of Levofloxacin: Increasing Incidence of Hypersensitivity to Fluoroquinolones."
3.	Cephalosporins (Cephalosporin Antibiotics)IBA 01/01/2022 - "The present study examined the clinical features of cephalosporin-induced Kounis syndrome and provided references for diagnosis, prevention, treatment, and prognosis. " 01/01/2022 - "Kounis syndrome is a serious adverse reaction to cephalosporin. " 01/01/2022 - "We collected cephalosporin-induced Kounis syndrome case reports by searching Chinese and English databases from the establishment of the database to October 31, 2021. " 01/01/2022 - "Cephalosporins are an increasingly encountered cause of Kounis syndrome. " 01/01/2022 - "Analysis of Clinical Features of Kounis Syndrome Induced by Cephalosporin."
4.	gadobenic acid (gadobenate dimeglumine)FDA Link 07/01/2019 - "The Unusual Suspect: Gadobenate-Dimeglumine Induced Kounis Syndrome." 07/01/2019 - "A male in their late 30's presented with non-ST elevation myocardial infarction suspected to be secondary to Kounis syndrome after gadobenate dimeglumine contrast media was used for an imaging study. "
5.	Epinephrine (Adrenaline)FDA LinkGeneric 11/15/2015 - "Kounis syndrome with Samter-Beer triad treated with intracoronary adrenaline." 01/26/2012 - "Kounis syndrome during general anaesthesia and administration of adrenaline." 10/24/2023 - "The onset of Kounis syndrome, takotsubo cardiopathy, or the paradoxical anaphylaxis require great attention in the management of anaphylaxis and adrenaline administration by clinicians, who should be aware of the undervalued evolution of anaphylaxis and the potential cardiologic complications of epinephrine administration. " 01/01/2023 - "The term "ATAK" complex has been coined by the association of adrenaline, takotsubo, anaphylaxis and Kounis syndrome. " 10/01/2021 - "Kounis syndrome occurs secondary to mast cell degranulation ultimately resulting in coronary vasospasm, platelet activation and inflammatory response, whereas epinephrine causes platelet aggregation. "
6.	AllergensIBA 11/01/2022 - "Kounis syndrome should be suspected in the ED in young patients with no cardiovascular risk factors after exposure to an allergen." 03/20/2020 - "A case of type I Kounis syndrome caused by double allergens." 07/01/2015 - "It is important to appropriately recognize and treat Kounis syndrome in patients with exposure to a documented allergen. " 01/01/2014 - "The accurate incidence of Kounis syndrome is not known, but since it was described, many clinical cases have been reported, showing the occurence due to various allergens. " 04/01/2023 - "An acute coronary syndrome due to mast-cell activation in the presence of an allergen is known as Kounis Syndrome (KS). "
7.	Amoxicillin (Wymox)FDA LinkGeneric 01/01/2022 - "Background: The available evidence suggests that amoxicillin is often associated with the occurrence of Kounis syndrome (KS). " 01/01/2022 - "Clinical features, diagnosis and management of amoxicillin-induced Kounis syndrome." 04/01/2018 - "Considering possible hypersensitive reaction of amoxicillin in the absence of major cardiovascular risk in the young patient, diagnosis of Kounis syndrome (KS) was inferred. " 04/01/2018 - "Kounis syndrome induced by amoxicillin following vasospastic coronary event in a 22-year-old patient: a case report." 07/01/2014 - "Kounis syndrome following the performance of skin test to amoxicillin."
8.	TroponinIBA 01/01/2020 - "Kounis syndrome was documented by transient ST depression and elevation of troponin. " 04/01/2015 - "This patient's ST segment elevation and troponin elevation was due to Kounis syndrome. " 11/01/2012 - "Two questions for Kounis syndrome: can we use magnetic resonance imaging in the diagnosis and does ST elevation correlates with troponin levels?" 05/31/2012 - "Subclinical and clinical presentation of Kounis syndrome: another cause of troponin elevation?" 10/01/2021 - "Many patients presenting with CAS crises have non-diagnostic ECGs and normal serum troponin concentrations, but CAS can be suspected on the basis of history and association with migraine, Raynaud's phenomenon and Kounis syndrome. "
9.	Amoxicillin-Potassium Clavulanate Combination (Co-amoxiclav)FDA Link 12/01/2016 - "Amoxicillin/clavulanic acid use may cause Kounis syndrome. " 10/01/2016 - "Kounis syndrome associated with amoxicillin/clavulanic acid." 03/26/2015 - "Kounis syndrome secondary to amoxicillin/clavulanic acid administration: a case report and review of literature." 08/20/2013 - "An underdiagnosed syndrome; Kounis syndrome secondary to amoxicillin/clavulanic acid use in a 16 year-old child." 07/24/2009 - "Kounis syndrome secondary to amoxicillin/clavulanic acid use in a child."
10.	COVID-19 VaccinesIBA 06/01/2022 - "To our knowledge, this constitutes the first reported case of type 3 Kounis syndrome after COVID-19 vaccine administration. " 06/01/2022 - "Recurrent Kounis syndrome - a life-threatening event after COVID-19 vaccine administration." 10/01/2021 - "Type 1 Kounis Syndrome Induced by Inactivated SARS-COV-2 Vaccine." 08/01/2022 - "Acute coronary syndromes following COVID-19 vaccine application: Kounis syndrome or chance?" 01/01/2022 - "COVID-19 vaccine, myocardial infarction and Kounis syndrome."

Therapies and Procedures

1.	Stents 01/01/2017 - "Preventing Kounis syndrome by stent implantation: a reciprocal process?" 09/01/2021 - "It also suggests that type 3 Kounis syndrome must be suspected in cases of apparently unexplained "very late" stent thrombosis." 09/01/2021 - "Allergic Myocardial Infarction: An Unusual Cause of Stent Thrombosis." 03/01/2021 - "Kounis syndrome type III may be a frequently undiagnosed clinical entity, emphasising the importance of pathological examination of aspirated materials when implanting coronary stents and history-taking of allergies to stent metals." 03/01/2021 - "Uncommon but imperative cause of repeated acute stent thrombosis: Kounis syndrome type III."
2.	Therapeutics 03/26/2021 - "In patients with Kounis syndrome type I undergoing a normal coronary angiography, in the absence of specific guidelines, single antiplatelet therapy and CCB may be a reasonable approach." 01/01/2021 - "Therapeutic management in Kounis syndrome: allergen immunotherapy adjuvant to antithrombotic therapy." 10/01/2021 - "Therefore, treatment priorities of Kounis syndrome are treatment of allergy, treatment of vasospasm, and treatment with anti-platelet therapy and revascularization if coronary plaques are present. " 01/01/2018 - "All physicians should be aware of The Kounis syndrome and always keep that unique clinical entity in mind to recognize it promptly and direct the therapy at suppressing the allergic reaction." 07/01/2014 - "Clinical and therapeutic paradoxes concerning Kounis syndrome therapy, pathophysiology, clinical course and causality have been encountered during its clinical course. "
3.	Drug-Eluting Stents 05/01/2017 - "Kounis syndrome not induced but prevented by the implantation of a drug-eluting stent: a case report." 01/07/2011 - "Drug eluting stent-induced Kounis syndrome." 08/01/2013 - "To our knowledge, this is the first case of Kounis syndrome showing very late ST in a second-generation drug-eluting stent caused by wasp stings. " 03/22/2012 - "Late drug eluting stent thrombosis due to acemetacine: type III Kounis syndrome: Kounis syndrome due to acemetacine." 06/23/2008 - "Kounis syndrome and simultaneous multivessel acute coronary syndromes after successful drug-eluting stent implantation."
4.	Anesthesia 06/02/2022 - "A 46-year-old woman demonstrated refractory Kounis syndrome (KS) after induction of anesthesia. " 11/01/2019 - "Kounis syndrome is not just a single-organ but also a complex multisystem and multi-organ arterial clinical condition; it affects the coronary, mesenteric, and cerebral arteries and is accompanied by allergy–hypersensitivity–anaphylaxis involving the skin, respiratory, and vascular systems in the context of anesthesia, surgery, radiology, oncology, or even dental and psychiatric medicine; further, it has significantly influences both morbidity and mortality. " 02/01/2018 - "Allergic Angina Syndrome in Anesthesia and Diabetes." 04/01/2017 - "Occurrence of Kounis syndrome under anesthesia." 07/01/2018 - "Kounis syndrome in anesthesia: The coronary arteries as the primary target of anaphylaxis."
5.	General Anesthesia 06/02/2022 - "Early Use of ECMO for Refractory Kounis Syndrome Concealed by General Anesthesia-A Case Report." 04/01/2017 - "It is likely that his symptoms in the first general anesthesia were caused by Kounis syndrome. " 10/01/2011 - "Suspected recurrent anaphylaxis in different forms during general anesthesia: implications for Kounis syndrome." 07/31/2019 - "Kounis syndrome (KS) is defined as the occurrence of acute coronary syndrome (ACS) associated with an anaphylactic reaction, and there have only been a few reports of its occurrence under general anesthesia. " 12/01/2008 - "In this case report, we describe a 70-year-old male patient who sustained Kounis syndrome induced by cisatracurium administration immediately following induction of general anesthesia. "