Metamizole-Induced Type I Kounis Syndrome
  • Catarina Lameiras
    Department of Internal Medicine, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Portugal
  • Ana Corte-Real
    Department of Internal Medicine, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Portugal
  • Ana Órfão
    Department of Internal Medicine, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Portugal
  • Marta Mendes Lopes
    Department of Internal Medicine, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Portugal
  • Maria do Céu Dória
    Department of Internal Medicine, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Portugal

Keywords

Kounis syndrome, anaphylactic reaction, myocardial infarction, metamizole

Abstract

Kounis syndrome (KS) is defined as acute coronary syndrome (ACS) triggered by mast cell and platelet activation in the setting of allergic or anaphylactic insults. KS is a unique and complex cause of ACS and many cases may be missed due to its highly variable clinical manifestations. In this report, we present a case of KS type I triggered by metamizole in the absence of a previous history of allergy to this drug. Following the administration of metamizole, the patient developed generalized acute urticaria, chest pain and diaphoresis. Electrocardiography (ECG) showed ST-segment elevation suggestive of myocardial infarction complicated by ventricular tachycardia. No coronary disease was observed on coronary angiography. The cardiac manifestations of KS may be life-threatening, and so it is important to appropriately recognize and treat this condition.

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References

  • Kounis NG. Kounis syndrome: an update on epidemiology, pathogenesis, diagnosis and therapeutic management. Clin Chem Lab Med 2016;54(10):1545–1559.
  • Abdelghany M, Subedi R, Shah S, Kozman H. Kounis syndrome: a review article on epidemiology, diagnostic findings, management and complications of allergic acute coronary syndrome. Int J Cardiol 2017;232:1–4.
  • Kötter T, da Costa BR, Fässler M, Blozik E, Linde K, Jüni P, et al. Metamizole-associated adverse events: a systematic review and metaanalysis. PLoS One 2015;10(4): e0122918.
  • Brown SG. Cardiovascular aspects of anaphylaxis: implications for treatment and diagnosis. Curr Opin Allergy Clin Immunol 2005;5(4):359–364.
  • Fassio F, Losappio L, Antolin-Amerigo D, et al. Kounis syndrome: a concise review with focus on management. Eur J Intern Med 2016;30:7–10.

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    Published: 2021-02-08
    Issue: 2021: Vol 8 No 2 (view)

    How to cite:
    1.
    Lameiras C, Corte-Real A, Órfão A, Mendes Lopes M, Dória M do C. Metamizole-Induced Type I Kounis Syndrome. EJCRIM 2021;8 doi:10.12890/2021_002249.

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