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库尼斯综合征。关于一例临床病例。

Kounis syndrome. Apropos of a clinical case.

作者信息

Duarte Pedro, Costa Joana, Serena Cátia, Almeida Carla, Gouveia Sandra, Lourenço César, Costa Humberto, Paiva Clara

机构信息

Hospital do Divino Espírito Santo de Ponta Delgada, Ponta Delgada, Portugal.

出版信息

Rev Bras Ter Intensiva. 2020 Mar;32(1):149-152. doi: 10.5935/0103-507x.20200021. Epub 2020 May 8.

Abstract

Kounis syndrome, while an acute coronary syndrome, occurs in the context of a hypersensitivity reaction, allergies, or anaphylaxis and is subdivided into three types: coronary spasm in normal arteries, instability of plaques in atherosclerotic coronary arteries, and thrombosis of coronary stents. Herein, the case of a 73-year-old patient who, after administration of amoxicillin/clavulanic acid, went into cardiorespiratory arrest with evidence of ST-T segment elevation on electrocardiogram is reported. Coronarography revealed no obstructive lesions, and spontaneous resolution of electrocardiographic abnormalities was observed. A review of anamnesis with the family revealed a previous allergy to penicillin. The tryptase dosage was strongly positive. Kounis syndrome type 2 was diagnosed, and the clinical outcome was good.

摘要

库尼综合征虽然是一种急性冠状动脉综合征,但发生在过敏反应、过敏或过敏反应的背景下,可分为三种类型:正常动脉中的冠状动脉痉挛、动脉粥样硬化冠状动脉中的斑块不稳定以及冠状动脉支架血栓形成。在此,报告了一例73岁患者,在服用阿莫西林/克拉维酸后发生心肺骤停,心电图显示ST-T段抬高。冠状动脉造影显示无阻塞性病变,且观察到心电图异常自发消退。与家属回顾病史发现患者既往对青霉素过敏。类胰蛋白酶剂量检测呈强阳性。诊断为2型库尼综合征,临床结局良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c6e/7206957/bf00f340e008/rbti-32-01-0149-g01.jpg

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