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I型库尼斯综合征:环丙沙星引发的过敏性心肌梗死

Type I Kounis Syndrome: Allergic Myocardial Infarction Triggered by Ciprofloxacin.

作者信息

Krishnamoorthy Sangeetha, Kaur Rashpinder, Ameer Nazeera, Uzoma Amarachi A, Enemuo Nkechi R, Gopal Shwetha, Glenn Vernice

机构信息

Internal Medicine, Trinity Health Oakland, Michigan, USA.

Microbiology, Kalpana Chawla Government Medical College, Karnal, IND.

出版信息

Cureus. 2024 Jun 16;16(6):e62460. doi: 10.7759/cureus.62460. eCollection 2024 Jun.

Abstract

Kounis syndrome (KS), known as allergic myocardial infarction (MI), is an uncommon but potentially life-threatening disease characterized by acute coronary artery disease (CAD) in the setting of allergic reactions. KS is most frequently triggered by medication, and ciprofloxacin-induced KS-I is rarely reported. Here, we present a case of KS-I triggered by ciprofloxacin in a young female with no prior CAD. A 35-year-old female presented with sudden onset chest pain, diaphoresis, and lightheadedness, accompanied by itching, confusion, and collapse, shortly after taking oral ciprofloxacin. Her electrocardiogram showed inferior wall MI with elevated cardiac troponin levels. Urgent coronary angiography was unremarkable. Her condition improved after sublingual nitroglycerine, methylprednisolone, and intramuscular injection of epinephrine. This case highlights the importance of recognizing drug-induced allergic reactions as a potential cause of acute coronary events, particularly in young patients without traditional risk factors.

摘要

库尼斯综合征(KS),又称过敏性心肌梗死(MI),是一种罕见但可能危及生命的疾病,其特征为在过敏反应背景下发生急性冠状动脉疾病(CAD)。KS最常由药物引发,而环丙沙星诱发的I型KS鲜有报道。在此,我们报告一例由环丙沙星诱发的I型KS病例,患者为一名无既往CAD病史的年轻女性。一名35岁女性在口服环丙沙星后不久,突然出现胸痛、出汗和头晕,伴有瘙痒、意识模糊和虚脱。她的心电图显示下壁心肌梗死,心肌肌钙蛋白水平升高。紧急冠状动脉造影未见异常。舌下含服硝酸甘油、静脉注射甲泼尼龙和肌肉注射肾上腺素后,她的病情有所改善。该病例凸显了认识药物诱发的过敏反应作为急性冠状动脉事件潜在病因的重要性,尤其是在无传统危险因素的年轻患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f939/11250056/d0828dcdff57/cureus-0016-00000062460-i01.jpg

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