Kounis Syndrome During Anesthesia: Presentation of Indolent Systemic Mastocytosis: A Case Report.
Mastocytosis comprises a heterogeneous group of disorders characterized by mast cell accumulation and proliferation in distinct organs. Kounis syndrome is defined as the concurrence of acute coronary syndromes with mast cell activation in a setting of allergic or hypersensitivity reactions. This is the first reported case of an intraoperative Kounis syndrome as the onset of an indolent systemic mastocytosis probably triggered by succinylated gelatin infusion during general anesthesia. The presentation of this case is intended to contribute to the knowledge of mastocytosis and Kounis syndrome at the time of diagnostic workup during intraoperative anaphylaxis or myocardial ischemia.
From the Departments of *Anesthesiology, †Allergy, and §Cardiology, Hospital Universitario de Guadalajara, Castilla-La Mancha, Spain; ‡Department of Surgery, Hospital Universitario Quirónsalud Madrid, Madrid, Spain.
Elena
E
de la Fuente Tornero
Arantza
A
Vega Castro
Pedro Álvarez
PÁ
de Sierra Hernández
Javier
J
Balaguer Recena
Sofía Carmen
SC
Zaragoza Casares
Francisco Miguel
FM
Serrano Baylin
Paloma
P
Gallardo Culebradas
Beatriz
B
Amorós Alfonso
Jose Ramón
JR
Rodríguez Fraile
D000768:Anesthesia, General / Q000009:adverse effects*; D005780:Gelatin / Q000008:administration & dosage / Q000009:adverse effects*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D000074962:Kounis Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D034721:Mastocytosis, Systemic / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D008875:Middle Aged; D019637:Orthopedic Procedures; D010952:Plasma Substitutes / Q000008:administration & dosage / Q000009:adverse effects*; D012307:Risk Factors; D013386:Succinates / Q000008:administration & dosage / Q000009:adverse effects*
D010952:Plasma Substitutes; D013386:Succinates; C060085:succinylated gelatin; D005780:Gelatin