- 作者：Kang Erxun ; MD&lowast ; ; ; Liu Wei ; MM&dagger ; ; Qi Shuying ; MM&dagger ;
- 关键词：Kounis syndrome ; chronic autoimmune urticaria ; electrocardiogram ; angiocardiography ; cardiac troponin T
- 刊名：Journal of Emergency Medicine
- 出版年：2016
- 出版时间：January 2016
- 年：2016
- 卷：50
- 期：1
- 页码：37-40
- 全文大小：977 K
Case Report
The patient was a 31-year-old woman who suffered from chronic urticaria for nearly 3 years. Her urticaria became more serious 1 week before this visit and was accompanied by repeated attacks of cardiac symptoms. Autologous serum skin test and serum anti-high affinity immunoglobulin E receptor antibody test were positive for CAU. Her coronary artery pathological changes were confirmed by electrocardiogram (ECG), cardiac troponin T (cTnT) value, and angiocardiography. The patient was diagnosed with KS. After being treated with cetirizine, glucocorticoids, and azathioprine, the patient did not relapse during the first year of follow-up.
Why Should an Emergency Physician Be Aware of This?
When seeing a patient with intermittent exacerbations of chronic urticaria accompanied by repeated attacks of cardiac symptoms, emergency physicians should consider the diagnosis of KS. It is important to monitor changes in the ECG and cTnT value. Angiocardiography is necessary to eliminate myocardial infarction or unstable angina. Second-generation antihistamines and glucocorticoids are effective in the treatment of CAU and also alleviate coronary spasm. Another important consideration for the emergency physician is the fact that some first-generation antihistamines have the side effect of ventricular tachycardia or fibrillation, so it is better not to use these drugs to treat urticaria if KS is suspected.