We thank Kounis and coll. for their Letter to the Editor [
[1]
] commenting and congratulating for our recently published article “Kounis syndrome:
A concise review with focus on management” [
[2]
].- Fassio F.
- Losappio L.
- Antolin-Amerigo D.
- Peveri S.
- Pala G.
- Preziosi D.
- et al.
Kounis syndrome: a concise review with focus on management.
Eur J Intern Med. Jan 12, 2016; (pii: S0953-6205(15)00432-X)https://doi.org/10.1016/j.ejim.2015.12.004
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References
- Kounis syndrome: aspects on pathophysiology and management.Eur J Intern Med. 2016;
- Kounis syndrome: a concise review with focus on management.Eur J Intern Med. Jan 12, 2016; (pii: S0953-6205(15)00432-X)https://doi.org/10.1016/j.ejim.2015.12.004
- Serum tryptase detected during acute coronary syndrome is significantly related to the development of major adverse cardiovascular events after 2 years.Clin Mol Allergy. Jun 2, 2015; 13: 14https://doi.org/10.1186/s12948-015-0013-0
Article info
Publication history
Published online: February 25, 2016
Accepted:
February 12,
2016
Received in revised form:
February 11,
2016
Received:
February 8,
2016
Identification
Copyright
© 2016 Published by Elsevier B.V. on behalf of European Federation of Internal Medicine.
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- Kounis syndrome: Aspects on pathophysiology and managementEuropean Journal of Internal MedicineVol. 32
- PreviewWe read with the great interest the excellent and concise review of Filippo Fassio et al. [1] focused on Kounis syndrome and its treatment. Since the description of this syndrome has paved the possibility for prevention of the progression of coronary plaques to unstable lesions with inhibition of mast cell activation, that has been already achieved experimentally [2], we believe that the following observations and additions on its pathophysiology and management would be of value.
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- Kounis syndrome: A concise review with focus on managementEuropean Journal of Internal MedicineVol. 30
- PreviewKounis syndrome is defined as the co-incidental occurrence of an acute coronary syndrome with hypersensitivity reactions following an allergenic event and was first described by Kounis and Zavras in 1991 as an allergic angina syndrome. Multiple causes have been described and most of the data in the literature are derived from the description of clinical cases – mostly in adult patients – and the pathophysiology remains only partly explained. Three different variants of Kounis syndrome have been defined: type I (without coronary disease) is defined as chest pain during an acute allergic reaction in patients without risk factors or coronary lesions in which the allergic event induces coronary spasm that electrocardiographic changes secondary to ischemia; type II (with coronary disease) includes patients with pre-existing atheromatous disease, either previously quiescent or symptomatic, in whom acute hypersensitive reactions cause plaque erosion or rupture, culminating in acute myocardial infarction; more recently a type-III variant of Kounis syndrome has been defined in patients with preexisting coronary disease and drug eluting coronary stent thrombosis.
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