title: Foods, Drugs and Environmental Factors: Novel Kounis Syndrome Offenders.
abstract: Kounis syndrome is hypersensitivity coronary disorder induced by various types of environmental exposures, drugs, conditions and stents. Allergic, hypersensitivity, anaphylactic and anaphylactoid reactions are associated with this syndrome. The disorder manifests as coronary spasms, acute myocardial infarction and stent thrombosis and affects the cerebral and mesenteric as well as coronary arteries. Importantly, its manifestations are broad and its etiology is continuously increasing. Recently, a variety of unusual etiologies have been reported including Anisakis simplex, scombroid syndrome, the use of Gelofusin or ultrasound contrast agents, kiwifruit, fly bites, and bee stings. Furthermore, losartan and the paradox of corticosteroid allergy have been implicated as possible causes. Although not rare, Kounis syndrome is infrequently diagnosed. Therefore, awareness of its etiology, manifestations and pathophysiology is important for providing the proper diagnosis and treatment and determining prognosis.
authors.affiliation: Department of Medical Sciences, Patras Highest Institute of Education and Technology, Greece.
authors.forename: Nicholas G
authors.initials: NG
authors.lastname: Kounis
authors.forename: Sotiris
authors.initials: S
authors.lastname: Giannopoulos
authors.forename: George D
authors.initials: GD
authors.lastname: Soufras
authors.forename: George N
authors.initials: GN
authors.lastname: Kounis
authors.forename: John
authors.initials: J
authors.lastname: Goudevenos
mesh_terms: D029042:Actinidia / Q000009:adverse effects / Q000276:immunology; D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000707:Anaphylaxis / Q000150:complications / Q000276:immunology*; D000959:Antihypertensive Agents / Q000009:adverse effects; D003287:Contrast Media / Q000009:adverse effects; D003329:Coronary Vasospasm / Q000150:complications / Q000276:immunology*; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D004781:Environmental Exposure / Q000009:adverse effects*; D006633:Histamine Antagonists / Q000627:therapeutic use; D006636:Histamine Release; D006801:Humans; D006969:Hypersensitivity, Immediate; D007299:Insect Bites and Stings / Q000276:immunology; D019808:Losartan / Q000009:adverse effects; D011379:Prognosis; D013577:Syndrome
chemical_list: D000305:Adrenal Cortex Hormones; D000959:Antihypertensive Agents; D003287:Contrast Media; D006633:Histamine Antagonists; D019808:Losartan