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A Case of Zaltoprofen Induced Kounis Syndrome

잘토프로펜 유발 Kounis 증후군 1례

  • Lee, Seong You (Department of Emergency Medicine, College of Medicine, Eulji University) ;
  • Sung, Won Young (Department of Emergency Medicine, College of Medicine, Eulji University) ;
  • Lee, Jang Young (Department of Emergency Medicine, College of Medicine, Eulji University) ;
  • Seo, Sang Won (Department of Emergency Medicine, College of Medicine, Eulji University) ;
  • Lee, Won Suk (Department of Emergency Medicine, College of Medicine, Eulji University)
  • 이성유 (을지대학교 의과대학 응급의학교실) ;
  • 성원영 (을지대학교 의과대학 응급의학교실) ;
  • 이장영 (을지대학교 의과대학 응급의학교실) ;
  • 서상원 (을지대학교 의과대학 응급의학교실) ;
  • 이원석 (을지대학교 의과대학 응급의학교실)
  • Received : 2019.03.28
  • Accepted : 2019.04.13
  • Published : 2019.06.30

Abstract

Kounis syndrome is defined as the occurrence of acute coronary syndrome associated with vasoactive mediators, such as histamines in the setting of hypersensitivity and allergic reactions or anaphylactic insults. The condition can be caused by various drugs, foods, or environmental factors that cause allergic reactions. A 35-year-old male visited the emergency room with anaphylaxis accompanied by chest pain approximately 20 minutes after taking zaltoprofen, a nonsteroidal anti-inflammatory drug. After acute treatment for the anaphylaxis, the patient was stabilized and all symptoms disappeared, but the ischemic changes in the electrocardiogram and elevation of the cardiac enzymes were observed. The emergency cardiac angiography and echocardiography were all normal. The allergic reaction of this patient to zaltoprofen was believed to cause a temporary coronary arterial vasospasm, inducing Type 1 Kounis syndrome. Thus far, there have been case reports of Kounis syndrome caused by a range of nonsteroidal anti-inflammatory drugs, but there are no reports of the condition being caused by zaltoprofen. According to the pathophysiology, both cardiac and allergic symptoms must be solved simultaneously, so rapid treatment and diagnosis are needed. Doctors treating acute allergic reactions and anaphylaxis patients must check the cardiovascular symptoms thoroughly and consider the possibility of Kounis syndrome.

Keywords

References

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