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Adult anaphylaxis: To the heart of the matter. Author's reply

Published:April 18, 2022DOI:https://doi.org/10.1016/j.ejim.2022.04.011
      we read with interest the letter by Mirijello et al. [
      • Mirijello A.
      • De Cosmo S.
      Adult anaphylaxis: to the heart of the matter.
      ] which emphasizes the importance of Kounis syndrome (KS), Takotsubo syndrome and their copresence in ATAK syndrome among cardiovascular manifestations of anaphylaxis. These are peculiar syndromes with yet uncompleted ascertained epidemiology (at least for KS) which may occur during anaphylaxis, complicate its course, and require special monitoring and management (namely exclusive intramuscular administration of adrenaline in a closely supervised setting for KS) [
      • Roumeliotis A.
      • Davlouros P.
      • Anastasopoulou M.
      • Tsigkas G.
      • Koniari I.
      • Mplani V.
      • et al.
      Allergy associated myocardial infarction: a comprehensive report of clinical presentation, diagnosis and management of Kounis syndrome.
      ,
      • Campbell R.L.
      • Bellolio M.F.
      • Knutson B.D.
      • Bellamkonda V.R.
      • Fedko M.G.
      • Nestler D.M.
      • Hess E.P.
      Epinephrine in anaphylaxis: higher risk of cardiovascular complications and overdose after administration of intravenous bolus epinephrine compared with intramuscular epinephrine.
      ].
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      References

        • Mirijello A.
        • De Cosmo S.
        Adult anaphylaxis: to the heart of the matter.
        Eur J Intern Med. 2022; https://doi.org/10.1016/j.ejim.2022.03.034
        • Roumeliotis A.
        • Davlouros P.
        • Anastasopoulou M.
        • Tsigkas G.
        • Koniari I.
        • Mplani V.
        • et al.
        Allergy associated myocardial infarction: a comprehensive report of clinical presentation, diagnosis and management of Kounis syndrome.
        Vaccines (Basel). 2021; 10: 38
        • Campbell R.L.
        • Bellolio M.F.
        • Knutson B.D.
        • Bellamkonda V.R.
        • Fedko M.G.
        • Nestler D.M.
        • Hess E.P.
        Epinephrine in anaphylaxis: higher risk of cardiovascular complications and overdose after administration of intravenous bolus epinephrine compared with intramuscular epinephrine.
        J Allergy Clin Immunol Pract. 2015; 3 (Jan-Feb): 76-80
        • Rossi C.M.
        • Lenti M.V.
        • Di Sabatino A.
        Adult anaphylaxis: a state-of-the-art review.
        Eur J Intern Med. 2022; (S0953-6205(22)00093-0)https://doi.org/10.1016/j.ejim.2022.03.003