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Minerva Pediatrica 2020 Sep 22

DOI: 10.23736/S0026-4946.20.06007-7

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Kounis syndrome: a pediatric perspective

Mattia GIOVANNINI 1 , Alessio ALLETTO 2, Ioanna KONIARI 3, Francesca MORI 1, Silvia FAVILLI 2, Lucrezia SARTI 1, Simona BARNI 1, Giulia LICCIOLI 1, Lorenzo LODI 4, Giuseppe INDOLFI 5, Elio NOVEMBRE 1, Nicholas G. KOUNIS 6

1 Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy; 2 Pediatric Cardiology Unit, Meyer Children's University Hospital, Florence, Italy; 3 Electrophysiology and Device Department, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK; 4 Division of Immunology, Section of Pediatrics, Department of Health Sciences, University of Florence and Meyer Children's Hospital, Florence, Italy; 5 Department of NEUROFARBA, University of Florence and Meyer Children's Hospital, Florence, Italy; 6 Department of Cardiology, Patras University School of Medicine, Patras, Greece


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Kounis syndrome is defined as a hypersensitivity coronary disorder constituted by the association of an acute coronary syndrome with a hypersensitivity, allergic, anaphylactic or anaphylactoid reaction, in a pathophysiologic context involving mast-cells, platelets, eosinophils and various interacting inflammatory cells. Currently, Kounis syndrome is established in the literature, as accompanied by a plethora of clinical case reports that further elucidating its aspects. To the best of our knowledge, a specific analysis regarding the pediatric data of Kounis syndrome has never been performed. The aim of this review is to reveal all the pediatric Kounis syndrome cases in the literature, in an attempt to define its clinical implications in children. Moreover, based on the data of this analysis, a new classification for Kounis syndrome is proposed, focusing mainly in the presence or the absence of allergic myocardial infarction, as the central clinical feature for the stratification of the patients’ clinical manifestations.


KEY WORDS: Kounis syndrome; Coronary syndrome; Hypersensitivity; Inflammation; Pediatrics

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