FIGURE 1.
FIGURE 2.
Kounis syndrome associated with idiopathic anaphylaxis
| Sandhu et al., 2017 | Keber et al., 2017 | |
|---|---|---|
| Country | USA | Slovenia |
| Patient profile | 65, female, with a history of malignant idiopathic anaphylaxis | 48, male |
| Trigger | Idiopathic anaphylaxis | Idiopathic anaphylaxis |
| Allergic symptoms | Present (facial flushing) | Present (skin changes, dyspnea) |
| Presentation | Chest pain | Chest pain, dyspnea, nausea |
| Coronary artery disease | No, confirmed by computed tomography angiography | No, confirmed by coronary angiography |
| Biomarkers | Troponin rise | Troponin rise, elevated tryptase during attacks |
| Electrocardiogram | NSTEMI | STEMI |
| Therapeutic management | Loratadine, famotidine, corticosteroids | Antihistamines |
Kounis syndrome associated with chronic spontaneous urticaria
| Erxun et al., 2016 | Brancaccio et al., 2024 | |
|---|---|---|
| Country | China | Italy |
| Patient profile | 31, female, chronic autoimmune urticaria | 47, female, chronic spontaneous urticaria |
| Trigger | No apparent trigger | No apparent trigger |
| Allergic symptoms | Erythema and wheals on trunk and limbs | Edema and wheals on lips and eyelids |
| Presentation | Chest pain, diaphoresis, palpitations | Chest pain |
| Coronary artery disease | No, confirmed by coronary angiography | No, confirmed by coronary angiography |
| Biomarkers | Troponin rise, serum anti-high affinity IgE receptor antibody test positive | Troponin rise, elevated tryptase during attacks |
| Electrocardiogram | STEMI | STEMI |
| Therapeutic management | Cetirizine, methylprednisolone and then prednisone, azathioprine | Cetirizine, prednisone, omalizumab |