Amoxicillin-induced Kounis syndrome manifesting as late stent thrombosis

Clinical features, diagnosis and management of amoxicillin-induced Kounis syndrome

“…Only 1 patient had normal ECG (3.0%). Echocardiography in 20 patients (60.6%) at the onset of KS showed normal in 13 patients (65.0%), hypokinesis in 9 patients (45.0%), and reduced ejection fraction in 3 patients (15.0%) ( Venturini et al, 2011 ; Canpolat et al, 2017 ; Caragnano et al, 2020 ). Coronary angiography in 28 patients showed normal in 14 patients (50.0%), stenosis in 12 patients (42.9%), and thrombosis in 2 patients (7.1%) ( Viana-Tejedor et al, 2011 ; Salouage et al, 2016 ).…”

“…Of the remaining 79 studies, 48 were excluded from the full-text review. A total of 31 studies were included ( Alemparte Pardavila et al, 1999 ; López-Abad et al, 2004 ; Moreno-Ancillo et al, 2004 ; Gikas et al, 2005 ; Del Furia et al, 2007 ; Tigen et al, 2007 ; Tavil et al, 2008 ; Vivas et al, 2008 ; Biteker et al, 2009 ; Caglar et al, 2011 ; Venturini et al, 2011 ; Viana-Tejedor et al, 2011 ; Mazarakis et al, 2012 ; Bezgin et al, 2013 ; Calf et al, 2013 ; Ilhan et al, 2013 ; Kilickesmez et al, 2013 ; Lombardi et al, 2013 ; González-de-Olano et al, 2014 ; Ralapanawa and Kularatne, 2015 ; Molina Anguita et al, 2016 ; Salouage et al, 2016 ; Shimi et al, 2016 ; Antonelli et al, 2017 ; Canpolat et al, 2017 ; Omri et al, 2017 ; Pradhan et al, 2018 ; Lopes and Agarwal, 2019 ; Moloney et al, 2019 ; Caragnano et al, 2020 ; Duarte et al, 2020 ). The basic information of these 33 patients is summarized in Table 1 .…”

“…There were 16 patients with other diseases, including hypertension in 8 patients (24.2%), dyslipidemia in 6 patients (18.2%), diabetes in 4 patients (12.1%), ischemic heart disease in 3 patients (9.1%). Eight patients (24.2%) had a history of smoking habits ( Vivas et al, 2008 ; Venturini et al, 2011 ; Mazarakis et al, 2012 ; Lombardi et al, 2013 ; Salouage et al, 2016 ; Pradhan et al, 2018 ; Caragnano et al, 2020 ). Four patients (12.1%) had previous history of penicillin-allergy ( Antonelli et al, 2017 ; Omri et al, 2017 ; Caragnano et al, 2020 ; Duarte et al, 2020 ).…”

“…Creatine kinase (CK) was reported in 15 patients(45.5%), with elevations in 10 patients (30.3%) ( Alemparte Pardavila et al, 1999 ; Moreno-Ancillo et al, 2004 ; Gikas et al, 2005 ; Tigen et al, 2007 ; Caglar et al, 2011 ; Viana-Tejedor et al, 2011 ; Bezgin et al, 2013 ; Antonelli et al, 2017 ; Pradhan et al, 2018 ; Duarte et al, 2020 ). Nine patients (27.3%) reported elevated creatine kinase-myocardial band (CK-MB) ( Moreno-Ancillo et al, 2004 ; Gikas et al, 2005 ; Tigen et al, 2007 ; Tavil et al, 2008 ; Biteker et al, 2009 ; Venturini et al, 2011 ; Bezgin et al, 2013 ; Kilickesmez et al, 2013 ; Omri et al, 2017 ). The serum tryptase levels were significantly elevated in 5 patients (15.2%) undergoing examination ( Biteker et al, 2009 ; González-de-Olano et al, 2014 ; Molina Anguita et al, 2016 ; Lopes and Agarwal, 2019 ; Duarte et al, 2020 ).…”

“…The remaining treatment options included steroids in 22 patients (66.7%), antihistamines in 20 patients (66.0%), epinephrine in 6 patients (18.2%), nitrate in 8 patients (24.2%), anti-platelet drugs in 14 patients (42.4%), anticoagulant drugs in 10 patients (30.3%), thrombolytic therapy in 1 patient (3.0%). Revascularization was performed in 9 patients (27.3%), including percutaneous coronary intervention (PCI) in 8 patients (24.2%), coronary artery bypass surgery (CABS) in 1 patient (3.0%) ( Alemparte Pardavila et al, 1999 ; Del Furia et al, 2007 ; Caglar et al, 2011 ; Venturini et al, 2011 ; Mazarakis et al, 2012 ; Lombardi et al, 2013 ; Antonelli et al, 2017 ; Omri et al, 2017 ; Moloney et al, 2019 ). Thirty-two patients (97.0%) recovered completely, and only one patient (3.0%) died ( Omri et al, 2017 ).…”