REVIEW  NOVEL INSIGHTS INTO PEDIATRIC ALLERGY AND IMMUNOLOGY Free access

Minerva Pediatrica 2020 October;72(5):383-92

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

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 elucidate 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 was 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; Acute coronary syndrome; Hypersensitivity; Inflammation; Pediatrics