Kounis Syndrome: Case Report in Goiânia/BR

Abstract 22-year-old male patient with no heart disease, who was given an ambulatory medication with analgesics due to an acute renal crisis. After the drug administration, the patient presented dyspnea, cyanosis, and hemoptysis. There was suspicion of anaphylactic shock, which was treated, but there was no improvement in the clinical condition. The patient was referred to the Intensive Care Unit, where tests were performed showing elevated cardiac enzymes and Immunoglobulin E and Computed Tomography of Thoracic revealed alveolar hemorrhage. He developed clinical worsening and died after sepsis. The final diagnosis was of kounis syndrome due to the hypersensitivity reaction to the analgesics introduced in the patient, generating an acute coronary syndrome (ACS). The purpose of this case report was to highlight a syndrome that is little reported because it is not part of the differential diagnosis routines of ACS, but it generates important complications.

摘要：患者为22岁男性，既往无心脏病史，因急性肾危象接受镇痛药物治疗。给药后，患者出现呼吸困难、发绀及咯血。临床怀疑为过敏性休克，予以针对性治疗但病情未见好转。患者被转入重症监护室，相关检查显示心肌酶与免疫球蛋白E（Immunoglobulin E）水平升高，胸部计算机断层扫描（Computed Tomography of Thoracic）提示肺泡出血。随后患者病情恶化，并发脓毒症后死亡。最终诊断为库尼斯综合征（Kounis syndrome），系患者对所使用的镇痛药物产生超敏反应，诱发急性冠脉综合征（ACS）。本病例报告旨在强调这一鲜有报道的综合征——因其未被纳入急性冠脉综合征的常规鉴别诊断流程，却可引发严重临床并发症。