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Review

Current understanding of Kounis syndrome

Pages 777-788 | Published online: 10 Jan 2014

Keep up to date with the latest research on this topic with citation updates for this article.

Read on this site (4)

Ka Roach & Jr Roberts. (2022) A comprehensive summary of disease variants implicated in metal allergy. Journal of Toxicology and Environmental Health, Part B 25:6, pages 279-341.
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Haoyu Wu, Yiwei Cao, Fengjun Chang, Chunyan Zhang, Yanchao Hu & Lei Liang. (2020) Kounis Syndrome Induced by Anisodamine: A Case Report. International Journal of General Medicine 13, pages 1523-1527.
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Volkan Dogan, Oğuzhan Çelik, Bülent Özlek, Eda Özlek, Cem Çil, Özcan Başaran & Murat Biteker. (2019) Allergic myocardial infarction: Type I Kounis syndrome following blue crab consumption. Acta Clinica Belgica 74:5, pages 375-377.
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Petrus Fourie. (2016) Kounis syndrome: a narrative review. Southern African Journal of Anaesthesia and Analgesia 22:2, pages 72-80.
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Articles from other publishers (77)

Taylor Cesarz & Latha Ganti. (2023) Kounis syndrome: ST elevations in the setting of anaphylaxis. Journal of Allergy and Clinical Immunology: Global 2:4, pages 100152.
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Ana V. Pejcic, Milos N. Milosavljevic, Slobodan Jankovic, Goran Davidovic, Marko M. Folic & Nevena D. Folic. (2023) Kounis Syndrome Associated With the Use of Diclofenac. Texas Heart Institute Journal 50:1.
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Rahul V. Annabathula, Mahesh A. Chandrasekhar & Luke A. Peters. (2023) Kounis Syndrome: A Sting to the Heart. Texas Heart Institute Journal 50:1.
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Chunjiang Wang, Weijin Fang, Liying Song, Zhenzhen Deng, Zuojun Li & Linli Sun. (2022) Analysis of Clinical Features of Non-steroidal Anti-inflammatory Drugs Induced Kounis Syndrome. Frontiers in Cardiovascular Medicine 9.
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Bryan Dai, John Cavaye, Mathew Judd, Jodie Beuth, Harish Iswariah & Usha Gurunathan. (2022) Perioperative Presentations of Kounis Syndrome: A Systematic Literature Review. Journal of Cardiothoracic and Vascular Anesthesia 36:7, pages 2070-2076.
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Talal Almas, Sarah Rehman, Eyad Mansour, Tarek Khedro, Ali Alansari, Jahanzeb Malik, Norah Alshareef, Vikneswaran Raj Nagarajan, Abdulla Hussain Al-Awaid, Reema Alsufyani, Majid Alsufyani, Ali Rifai, Ahlam Alzahrani, Dhineswaran Raj Nagarajan, Tala Abdullatif, Varman Gunasaegaram, Enaam Alzadjali, Arthi Subramanian, Abida Rahman, Yasar Sattar, Jason Galo, Hafeez Ul Hassan Virk & M. Chadi Alraies. (2022) Epidemiology, clinical ramifications, and cellular pathogenesis of COVID-19 mRNA-vaccination-induced adverse cardiovascular outcomes: A state-of-the-heart review. Biomedicine & Pharmacotherapy 149, pages 112843.
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林园 梁. (2022) Research Progress in Diagnosis and Treatment of Kounis Syndrome. Advances in Clinical Medicine 12:12, pages 11873-11878.
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Hui-zhu Liang, Hong Zhao, Jian Gao, Cheng-fu Cao & Wei-min Wang. (2021) Epirubicin-induced Kounis syndrome. BMC Cardiovascular Disorders 21:1.
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Freston Marc Sirur, William Wilson, Vivek Gopinathan, A.S. Chethana & Nymisha Lekha. (2021) Hymenoptera heartaches -cardiac manifestation with hymenoptera stings, a retrospective study from a tertiary care hospital in South India. The American Journal of Emergency Medicine 50, pages 294-300.
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İbrahim Halil Özdemir, Bülent Özlek, Mehmet Burak Özen, Ramazan Gündüz & Özgür Bayturan. (2021) Type 1 Kounis Syndrome Induced by Inactivated SARS-COV-2 Vaccine. The Journal of Emergency Medicine 61:4, pages e71-e76.
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Bülent Özlek, Eda Özlek & Aysel Gökçek. (2021) Reply to the letter: “Kounis syndrome: Towards a new classification”. International Journal of Cardiology 335, pages 25.
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Apostolos Dimos, Andrew Xanthopoulos, Dimitrios Bismpos, Filippos Triposkiadis & John Skoularigis. (2021) Delayed Acute Coronary Syndrome Caused by Multiple Bee Stings: A Rare Case of Kounis Syndrome. Cureus.
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SachinT Rao, Harsha Basappa, Hema Raveesh, Srinidhi Hegde & CN Manjunath. (2021) Acute Coronary syndrome following honey bee sting: A series of 6 cases of “kounis syndrome” with literature review. JOURNAL OF INDIAN COLLEGE OF CARDIOLOGY 11:3, pages 98.
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Ömer Doğan Alataş & Emine Tugba Alataş. (2020) Isotretinoin-induced pruritic erythematous lesions and acute chest pain in a 15-year-old girl. The American Journal of Emergency Medicine 38:5, pages 1043.e1-1043.e3.
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Engin ÖZAKIN, Volkan ERCAN & Kadir Uğur MERT. (2020) Kounis Sendromu. OSMANGAZİ JOURNAL OF MEDICINE.
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Yi-Xuan Zhang, Lu LiuLi-Ping Liu, Hui Xu & Yu-Mei Li. (2020) A case of type I Kounis syndrome caused by double allergens. Chinese Medical Journal:6, pages 735-737.
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Vikrant Tambe, Ajay Tambe, Alexandra Goodman & Zachary Shepherd. (2020) Carboplatin-Induced Kounis Syndrome. American Journal of Therapeutics 27:6, pages e647-e652.
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Mar Guilarte, Victoria Cardona & Moises Labrador-Horrillo. (2019) Kounis Syndrome. Current Treatment Options in Allergy 6:3, pages 289-296.
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Eda Özlek, Funda Sungur Biteker, Oğuzhan Çelik, Bülent Özlek, Cem Çil & Murat Biteker. (2019) Gemifloxacin-Induced Allergic Myocardial Infarction: A Case Report. The Journal of Emergency Medicine 56:6, pages e103-e105.
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Karine Lambert, Rexson Tse, Camilla Tettamanti, Maria Pia Scarpelli, Guillaume Rousseau, Alessandro Bonsignore & Cristian Palmiere. (2019) Postmortem IgE determination in coronary artery disease. Journal of Forensic and Legal Medicine 62, pages 1-6.
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Cesare Tripolino, Eliezer Joseph Tassone, Gaetano Morabito, Placido Grillo & Bindo Missiroli. (2019) Acute coronary stent thrombosis: A case of type 3 Kounis syndrome. Journal of Cardiology Cases 19:1, pages 33-35.
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平良 隆行 (Takayuki Taira)迫田 直樹 (Naoki Sakota)中川 儀英 (Yoshihide Nakagawa)猪口 貞樹 (Sadaki Inokuchi). (2019) 交通事故で救急搬送されたKounis症候群を疑われた1例(A case of suspected Kounis syndrome carried emergency in a traffic accident). Nihon Kyukyu Igakukai Zasshi: Journal of Japanese Association for Acute Medicine 30:1, pages 15-19.
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Itziar Palacios-Zabalza, Eulalia Camino-Rodríguez & Carmelo Aguirre. (2018) Síndrome de Kounis inducido por ranitidina. Medicina Clínica 151:9, pages e51-e53.
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Itziar Palacios-Zabalza, Eulalia Camino-Rodríguez & Carmelo Aguirre. (2018) Kounis syndrome induced by ranitidine. Medicina Clínica (English Edition) 151:9, pages e51-e53.
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Volkan Dogan. (2018) A case of Kounis syndrome associated with branched-chain amino acid supplementation in a 17-year-old boy. Cardiology in the Young 28:10, pages 1165-1167.
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Güney Sarıoğlu, Ertugrul Kurtoglu, Tolga Çakmak, Fatih Güngören & Şıho Hidayet. (2018) Kounis syndrome due to oral intake of diclofenac potassium: A case report, Diklofenak potasyumun oral alımına bağlı Kounis sendromu: Olgu Sunumu. Bozok Tıp Dergisi.
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Ayako Okuno, Yuka Matsuki, Mari Tabata & Kenji Shigemi. (2018) A suspected case of coronary vasospasm induced by anaphylactic shock caused by rocuronium-sugammadex complex. Journal of Clinical Anesthesia 48, pages 7.
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Bülent Özlek, Eda Özlek, Oğuzhan Çelik, Cem Çil, Volkan Doğan & Murat Biteker. (2018) Allergic myocardial infarction following recombinant human insulin. Heart & Lung 47:4, pages 360-362.
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Tolga Çakmak, İbrahim Çaltekin, Emre Gökçen, Atakan Savrun & Erdoğan Yaşar. (2018) Kounis syndrome due to hirudotherapy (leech therapy) in emergency department; a case report. Turkish Journal of Emergency Medicine 18:2, pages 85-87.
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Matthew Luke Di Toro & Dion Stub. (2018) Kounis Syndrome: A Case Report and Literature Review of Pre-Hospital Treatment. Australasian Journal of Paramedicine 15, pages 1-7.
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Murat Biteker, Funda Sungur Biteker, Bülent Özlek, Eda Özlek & Nesrin Başaran. (2017) Classification of Kounis syndrome. International Journal of Cardiology 247, pages 13.
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Pablo Alejandro Villamil-Munévar & Luis F. Sánchez-Solanilla. (2017) Síndrome de Kounis o angina alérgica. Revista Colombiana de Cardiología 24:4, pages 382-387.
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Mahmut Yesin, Macit Kalçık, Mustafa Ozan Gürsoy, Süleyman Karakoyun, Metin Çağdaş & Mehmet Özkan. (2017) Acute myocardial infarction in a patient suffering from penicillin-induced laryngeal edema. Wiener klinische Wochenschrift 129:13-14, pages 509-511.
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Nikolaos V. Cholevas, Loukianos S. Rallidis, Aglaia Staurothanasopoulou, Eumorfia Pagaki & Dimitrios Platogiannis. (2017) Kounis syndrome type I in a victim of cardiopulmonary arrest after hymenoptera sting. Journal of Cardiology Cases 15:4, pages 141-144.
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Mahmoud Abdelghany, Rogin Subedi, Siddharth Shah & Hani Kozman. (2017) Kounis syndrome: A review article on epidemiology, diagnostic findings, management and complications of allergic acute coronary syndrome. International Journal of Cardiology 232, pages 1-4.
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Masafumi Suga, Akira Inoue, Akihiro Takaba, Koichi Ariyoshi, Ryutaro Seo, Takashi Yoshizawa, Shuichiro Kaji & Yutaka Furukawa. (2017) Kounis syndrome with contrast medium treated with percutaneous coronary intervention. Nihon Shuchu Chiryo Igakukai zasshi Journal of the Japanese Society of Intensive Care Medicine 24:3, pages 341-344.
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Shanker Kundumadam, Vivek Reddy, Sagar Mallikethi Reddy, Pradeep Kathi & Aiden Abidov. (2017) An Unusual Case of Recurrent Hypersensitivity Reaction Associated with Kounis-Like Acute Coronary Syndrome. Case Reports in Cardiology 2017, pages 1-3.
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João Almeida, Sara Ferreira, Joana Malheiro, Paulo Fonseca, Daniel Caeiro, Adelaide Dias, José Ribeiro & Vasco Gama. (2016) A rare cause of acute coronary syndrome: Kounis syndrome. Revista Portuguesa de Cardiologia (English Edition) 35:12, pages 699.e1-699.e4.
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João Almeida, Sara Ferreira, Joana Malheiro, Paulo Fonseca, Daniel Caeiro, Adelaide Dias, José Ribeiro & Vasco Gama. (2016) Causa rara de síndrome coronária aguda: síndrome de Kounis. Revista Portuguesa de Cardiologia 35:12, pages 699.e1-699.e4.
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P. Bharadwaj, A. Joshi, Anup Banerji & Navreet Singh. (2016) Kounis syndrome: Acute myocardial injury caused by multiple bee stings. Medical Journal Armed Forces India 72, pages S178-S181.
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Nicholas G. Kounis. (2016) Kounis syndrome: an update on epidemiology, pathogenesis, diagnosis and therapeutic management. Clinical Chemistry and Laboratory Medicine (CCLM) 54:10, pages 1545-1559.
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Lawrence B. Afrin. (2016) Mast cell activation disease and the modern epidemic of chronic inflammatory disease. Translational Research 174, pages 33-59.
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James H. Diaz. (2016) A Wasp Sting and a Broken Heart. Wilderness & Environmental Medicine 27:2, pages 326-329.
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Filippo Fassio, Laura Losappio, Dario Antolin-Amerigo, Silvia Peveri, Gianni Pala, Donatella Preziosi, Ilaria Massaro, Gabriele Giuliani, Chiara Gasperini, Marco Caminati & Enrico Heffler. (2016) Kounis syndrome: A concise review with focus on management. European Journal of Internal Medicine 30, pages 7-10.
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Daniela Benedetto, Pierfrancesco Agostoni, Eric de Waal & Pieter R. Stella. (2015) Kounis syndrome with cardiogenic shock during transfemoral transcatheter aortic valve replacement. Coronary Artery Disease 26:8, pages 726-727.
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Guo-Ping Shi, Ilze Bot & Petri T. Kovanen. (2015) Mast cells in human and experimental cardiometabolic diseases. Nature Reviews Cardiology 12:11, pages 643-658.
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Zhang Liping, Hui Bin & Feng Qiming. (2015) An Extraordinary Case Associated with an Allergic Reaction to Clopidogrel: Coronary Artery Spasm or Kounis Syndrome?. Heart, Lung and Circulation 24:11, pages e180-e183.
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Ümit Yüksek & Murat Erden. (2015) A case of Kounis syndrome with anaphylactic shock secondary to penicillin G injection in a 32-year old woman. International Journal of the Cardiovascular Academy 1:2-3, pages 43-44.
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Birdal Yildirim, Ibrahim Altun, Volkan Dogan, Mustafa Ozcan Soylu & Murat Biteker. (2015) A forgotten cause of acute coronary syndrome: Allergic myocardial infarction. The American Journal of Emergency Medicine 33:9, pages 1314-1315.
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P. Mur Gimeno, N. Parias Ángel, M. Crespín Crespín, F. Ceres Alabau, R. Llamazares & E. Sancho Calatrava. (2015) Anafilaxia poco frecuente y adenoma suprarrenal funcionante. Revista Clínica Española 215:3, pages e17-e19.
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Gurbet Özge Mert, Funda Sungur Biteker, Kadir Uğur Mert, Özcan Başaran, Volkan Doğan & Murat Biteker. (2015) Takotsubo cardiomyopathy or Kounis syndrome or both?. International Journal of Cardiology 179, pages 16.
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Funda Sungur Biteker, Volkan Dogan, Kadir Ugur Mert, Gurbet Ozge Mert & Murat Biteker. (2014) Kounis syndrome and antibiotics. Annals of Saudi Medicine 34:6, pages 556-556.
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George D. Soufras, George Hahalis & Nicholas G. Kounis. (2014) Thrombotic complications associated with transcatheter aortic valve implantation: the role of Kounis hypersensitivity-associated thrombotic syndrome. Cardiovascular Pathology 23:6, pages 383-384.
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Francisco Vega, Tania Ramos, Paloma Las Heras & Carlos Blanco. (2014) Kounis syndrome associated with brain injury after Hymenoptera sting: New presentation of an established entity. International Journal of Cardiology 176:1, pages e29-e31.
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Akram Abdeljaber Saleh. (2014) Kounis syndrome: acute inferior myocardial infarction with atroventricular node block due to ceftriaxone: a first reported case. Annals of Saudi Medicine 34:3, pages 250-253.
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G. D. Soufras, G. N. Kounis & N. G. Kounis. (2014) Brain injury due to anaphylactic shock: broadening manifestations of Kounis syndrome. International Endodontic Journal 47:4, pages 309-313.
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Michail Alevizos, Anna Karagkouni, Smaro Panagiotidou, Magdalini Vasiadi & Theoharis C. Theoharides. (2014) Stress triggers coronary mast cells leading to cardiac events. Annals of Allergy, Asthma & Immunology 112:4, pages 309-316.
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Maria Teresa Cardillo, Roberta Della Bona, Eloisa Basile, Riccardo Marano & Luigi Marzio Biasucci. (2013) Hypersensitivity myocarditis or Kounis syndrome?. Internal and Emergency Medicine 9:2, pages 247-248.
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Takeshi Haoka, Yuka Morishita, Yuki Naito, Shinsuke Onishi, Satoshi Nara & Isao Takahashi. (2014) Kounis syndrome presenting with anaphylaxis and vasospastic angina: a case report. Nihon Kyukyu Igakukai Zasshi Nihon Kyukyu Igakukai Zasshi 25:10, pages 785-791.
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George D. Soufras, George Hahali & Nicholas G. Kounis. (2014) Relation Between White Blood Cell Count and Infarct Size: What About Differential?. The American Journal of Cardiology 113:2, pages 412.
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Nicholas G. Kounis, George D. Soufras, George N. Kounis & George Hahalis. (2013) Suicidal anaphylactic death: Is Kounis anaphylaxis associated syndrome the cause?. Forensic Science International 232:1-3, pages e42-e43.
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Michele Correale, Francesco Santoro, Riccardo Ieva, Matteo Di Biase & Natale Daniele Brunetti. (2013) Tako-Tsubo cardiomyopathy or allergic acute coronary syndrome: that is the question. Internal and Emergency Medicine 8:7, pages 639-639.
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Preciosa M. Coloma, Martijn J. Schuemie, Gianluca Trifirò, Laura Furlong, Erik van Mulligen, Anna Bauer-Mehren, Paul Avillach, Jan Kors, Ferran Sanz, Jordi Mestres, José Luis Oliveira, Scott Boyer, Ernst Ahlberg Helgee, Mariam Molokhia, Justin Matthews, David Prieto-Merino, Rosa Gini, Ron Herings, Giampiero Mazzaglia, Gino Picelli, Lorenza Scotti, Lars Pedersen, Johan van der Lei & Miriam Sturkenboom. (2013) Drug-Induced Acute Myocardial Infarction: Identifying ‘Prime Suspects’ from Electronic Healthcare Records-Based Surveillance System. PLoS ONE 8:8, pages e72148.
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Nicholas G. Kounis. (2013) Coronary Hypersensitivity Disorder: The Kounis Syndrome. Clinical Therapeutics 35:5, pages 563-571.
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Jung Hwa MinMin-Ho Kang. (2013) Kounis Syndrome Presenting as Very Late Stent Thrombosis in an Everolimus-Eluting Stent Following Wasp Stings. Korean Circulation Journal 43:8, pages 561.
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Se Jin Lee. (2013) The Author Response: Suspected Anaphylactic Reaction Associated with Microemulsion Propofol during Anesthesia Induction. Journal of Korean Medical Science 28:4, pages 640.
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Francisco J. Garcipérez de Vargas, Javier Mendoza, Pablo Sánchez-Calderón, Carolina Ortiz, Rosa Porro & María V. Mogollón-Jiménez. (2012) Shock cardiogénico secundario a síndrome de Kounis tipo II inducido por metamizol. Revista Española de Cardiología 65:12, pages 1138-1139.
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Francisco J. Garcipérez de Vargas, Javier Mendoza, Pablo Sánchez-Calderón, Carolina Ortiz, Rosa Porro & María V. Mogollón-Jiménez. (2012) Cardiogenic Shock Secondary to Metamizole-induced Type II Kounis Syndrome. Revista Española de Cardiología (English Edition) 65:12, pages 1138-1139.
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Ayhan Akoz, Atif Bayramoglu, Mustafa Uzkeser, Mecit Kantarci, Enbiya Aksakal & Mucahit Emet. (2012) Two questions for Kounis syndrome: can we use magnetic resonance imaging in the diagnosis and does ST elevation correlates with troponin levels?. The American Journal of Emergency Medicine 30:9, pages 2086.e5-2086.e7.
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D.A. Rodríguez-Serrano, I. Torrejón-Pérez, A. Abella-Álvarez & A. Elices. (2012) Síndrome de Kounis tipo I. Revista Clínica Española 212:9, pages 472-473.
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Nicholas G Kounis, Grigorios G Tsigkas, George Almpanis & Andreas Mazarakis. (2011) Kounis syndrome is likely culprit of coronary vasospasm induced by capecitabine. Journal of Oncology Pharmacy Practice 18:2, pages 316-318.
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P. Rico Cepeda, E. Palencia Herrejón & M.M. Rodríguez Aguirregabiria. (2012) Kounis syndrome. Medicina Intensiva (English Edition) 36:5, pages 358-364.
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P. Rico Cepeda, E. Palencia Herrejón & M.M. Rodríguez Aguirregabiria. (2012) Síndrome de Kounis. Medicina Intensiva 36:5, pages 358-364.
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Robert Y. Lin & Paola Palomino Guillen. (2012) Acute coronary thrombosis after anaphylactic shock treatment. Annals of Allergy, Asthma & Immunology 108:5, pages 380-381.
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Nicholas G. Kounis, Sotiris Giannopoulos, Grigorios G. Tsigkas & John Goudevenos. (2012) Eosinophilic responses to stent implantation and the risk of Kounis hypersensitivity associated coronary syndrome. International Journal of Cardiology 156:2, pages 125-132.
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Christian Leli. (2011) Asymptomatic acute myocardial injury during allergic reaction to hymenoptera venom. Internal and Emergency Medicine 7:2, pages 189-191.
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Nicholas G KounisAndreas Mazarakis, Grigorios Tsigkas, Sotiris Giannopoulos & John Goudevenos. (2011) Kounis syndrome: a new twist on an old disease. Future Cardiology 7:6, pages 805-824.
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