Wajtryt Olga, Zielonka Tadeusz M, Kaszyńska Aleksandra, Falkowski Andrzej, Życińska Katarzyna
Klinika Chorób Wewnętrznych i Metabolicznych, Szpital Czerniakowski w Warszawie, Warszawa, Polska.
Klinika Chorób Wewnętrznych i Metabolicznych, Szpital Czerniakowski w Warszawie, Warszawa, Polska, Katedra i Zakład Medycyny Rodzinnej, Warszawski Uniwersytet Medyczny, Warszawa, Polska.
Wiad Lek. 2019;72(1):137-141.
Kounis syndrome or allergic myocardial infarction is an acute coronary syndrome in the course of an allergic reaction. In allergic patients in response to a specific condition - nourishment, inhalation, environmental substances, drug or insect bite there is an allergic reaction involving many different cells and mediators that can cause coronary artery spasm or initiate the process of rupture and activation of atherosclerotic plaque resulting in acute coronary syndrome. The paper describes a case of a young man with allergy to pollen and confirmed sensitization to nuts, who developed a full-blown anaphylactic shock after eating the nut mix and experienced a rapidly passing acute coronary syndrome with troponin up to 4.7 μg/L. An increased concentration of tryptase (15 μg/L), total IgE (> 3,000 IU/mL) and specific anti-nut IgE (55.1 kUA/L) were found. Based on the course of the disease and the results of allergic and cardiac tests, allergic type 1 myocardial infarction, i.e. caused by coronary artery spasm, was diagnosed. During the hospitalization, the patient's condition improved quickly and after a few days he left the hospital without the signs of permanent damage to the heart muscle.
库尼斯综合征或过敏性心肌梗死是过敏反应过程中的一种急性冠状动脉综合征。在过敏患者中，针对特定情况——营养、吸入物、环境物质、药物或昆虫叮咬，会发生涉及许多不同细胞和介质的过敏反应，这可能导致冠状动脉痉挛或引发动脉粥样硬化斑块破裂和激活过程，从而导致急性冠状动脉综合征。本文描述了一名对花粉过敏且证实对坚果过敏的年轻男子的病例，他在食用坚果混合物后发生了严重的过敏性休克，并经历了快速缓解的急性冠状动脉综合征，肌钙蛋白高达4.7μg/L。发现类胰蛋白酶浓度升高（15μg/L）、总IgE（>3000IU/mL）和特异性抗坚果IgE（55.1kUA/L）。根据疾病过程以及过敏和心脏检查结果，诊断为1型过敏性心肌梗死，即由冠状动脉痉挛引起。住院期间，患者病情迅速好转，几天后出院，未出现心肌永久性损伤的迹象。
