Kounis syndrome. Apropos of a clinical case

ABSTRACT Kounis syndrome, while an acute coronary syndrome, occurs in the context of a hypersensitivity reaction, allergies, or anaphylaxis and is subdivided into three types: coronary spasm in normal arteries, instability of plaques in atherosclerotic coronary arteries, and thrombosis of coronary stents. Herein, the case of a 73-year-old patient who, after administration of amoxicillin/clavulanic acid, went into cardiorespiratory arrest with evidence of ST-T segment elevation on electrocardiogram is reported. Coronarography revealed no obstructive lesions, and spontaneous resolution of electrocardiographic abnormalities was observed. A review of anamnesis with the family revealed a previous allergy to penicillin. The tryptase dosage was strongly positive. Kounis syndrome type 2 was diagnosed, and the clinical outcome was good.

【摘要】库尼斯综合征（Kounis syndrome）虽归属于急性冠状动脉综合征，但其发病与超敏反应、过敏或过敏性休克密切相关，可分为三型：正常冠状动脉的冠脉痉挛、动脉粥样硬化性冠状动脉的斑块不稳定，以及冠状动脉支架内血栓形成。本文报告1例73岁患者，该患者在接受阿莫西林克拉维酸给药后出现心搏骤停，心电图（electrocardiogram）检查提示ST-T段抬高。冠状动脉造影术（Coronarography）未见阻塞性病变，且心电图异常表现自发缓解。经向家属追溯既往病史，确认患者既往有青霉素过敏史。类胰蛋白酶（tryptase）检测结果呈强阳性。最终确诊为2型库尼斯综合征，患者临床预后良好。