{"title":"一例过敏性休克后反复出现的库尼斯综合征：疾病管理注意事项","authors":"Satoshi Kawaguchi, Tatsuki Kuroshima, Ryo Namba, Hiroki Satou, Riku Kashiwagi, Ai Abe, Motoi Okada","doi":"10.1002/ams2.908","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Kounis syndrome (KS) is an underdiagnosed disease. The management of the disease remains elusive because of its infrequency.</p>\n </section>\n \n <section>\n \n <h3> Case Presentation</h3>\n \n <p>A 78-year-old man with anaphylactic shock was admitted to our hospital 2 h after multiple bee stings. After recovering from an anaphylactic reaction, he presented with chest pain with ST elevation. We diagnosed him with KS. After a continuous intravenous infusion of vasodilators, his chest pain and ST elevation improved. However, chest pain with ST-segment elevation recurred the next day. Coronary angiography revealed severe stenosis in the middle left anterior descending coronary artery, and drug-eluting stents were implanted. The patient was discharged on foot after treatment for heart failure.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>KS, in which anaphylaxis and acute coronary syndrome occur simultaneously, can recur repeatedly after an initial anaphylactic reaction; however, it could be delayed or it could present simultaneously with the anaphylactic reaction. Therefore, long-term observation is important.</p>\n </section>\n </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.908","citationCount":"0","resultStr":"{\"title\":\"A case of repeated Kounis syndrome after anaphylactic shock: A note for disease management\",\"authors\":\"Satoshi Kawaguchi, Tatsuki Kuroshima, Ryo Namba, Hiroki Satou, Riku Kashiwagi, Ai Abe, Motoi Okada\",\"doi\":\"10.1002/ams2.908\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Kounis syndrome (KS) is an underdiagnosed disease. The management of the disease remains elusive because of its infrequency.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Case Presentation</h3>\\n \\n <p>A 78-year-old man with anaphylactic shock was admitted to our hospital 2 h after multiple bee stings. After recovering from an anaphylactic reaction, he presented with chest pain with ST elevation. We diagnosed him with KS. After a continuous intravenous infusion of vasodilators, his chest pain and ST elevation improved. However, chest pain with ST-segment elevation recurred the next day. Coronary angiography revealed severe stenosis in the middle left anterior descending coronary artery, and drug-eluting stents were implanted. The patient was discharged on foot after treatment for heart failure.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>KS, in which anaphylaxis and acute coronary syndrome occur simultaneously, can recur repeatedly after an initial anaphylactic reaction; however, it could be delayed or it could present simultaneously with the anaphylactic reaction. Therefore, long-term observation is important.</p>\\n </section>\\n </div>\",\"PeriodicalId\":7196,\"journal\":{\"name\":\"Acute Medicine & Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-02-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.908\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acute Medicine & Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/ams2.908\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acute Medicine & Surgery","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ams2.908","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景库尼斯综合征（KS）是一种诊断不足的疾病。由于该病并不常见，其治疗方法仍然难以捉摸。 病例介绍 一名患有过敏性休克的 78 岁男性在多次被蜜蜂蜇伤 2 小时后被送入我院。从过敏性休克反应中恢复后，他出现胸痛并伴有 ST 段抬高。我们诊断他患有 KS。在持续静脉输注血管扩张剂后，他的胸痛和 ST 段抬高症状有所改善。但第二天，胸痛伴 ST 段抬高再次出现。冠状动脉造影显示左前降支冠状动脉中段严重狭窄，于是植入了药物洗脱支架。患者在接受心力衰竭治疗后步行出院。 结论 过敏性休克和急性冠状动脉综合征同时发生的 KS 可在初次过敏反应后反复复发，但可能会延迟或与过敏反应同时出现。因此，长期观察非常重要。
A case of repeated Kounis syndrome after anaphylactic shock: A note for disease management
Background
Kounis syndrome (KS) is an underdiagnosed disease. The management of the disease remains elusive because of its infrequency.
Case Presentation
A 78-year-old man with anaphylactic shock was admitted to our hospital 2 h after multiple bee stings. After recovering from an anaphylactic reaction, he presented with chest pain with ST elevation. We diagnosed him with KS. After a continuous intravenous infusion of vasodilators, his chest pain and ST elevation improved. However, chest pain with ST-segment elevation recurred the next day. Coronary angiography revealed severe stenosis in the middle left anterior descending coronary artery, and drug-eluting stents were implanted. The patient was discharged on foot after treatment for heart failure.
Conclusion
KS, in which anaphylaxis and acute coronary syndrome occur simultaneously, can recur repeatedly after an initial anaphylactic reaction; however, it could be delayed or it could present simultaneously with the anaphylactic reaction. Therefore, long-term observation is important.
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