Kounis Syndrome: A rare case of Omeprazol anaphylaxis
Journal: Advances in Medicine and Engineering Interdisciplinary Research DOI: 10.32629/ameir.v3i3.4065
Abstract
Anaphylaxis is a potentially fatal acute hypersensitivity reaction. Omeprazole has revolutionized the treatment of pathologies related to acid hypersecretion. Cases of anaphylactic reaction to proton pump inhibitors (PPIs) have been described. We present the case of a 30-year-old woman with acute gastroenteritis who immediately developed severe retrosternal pain, hypotension, and altered consciousness after taking intravenous omeprazole. There were signs of acute ischemia and increased markers of myocardial injury. She was admitted to the intensive care unit with good progress. Cases of severe anaphylaxis to PPIs are very rare; the mechanism is IgE-mediated, with a class effect and the possibility of cross-reaction with ranitidine. Kounis syndrome involves the association of type 2 acute myocardial infarction with anaphylactic shock. This adverse effect should be monitored, given the widespread use of PPIs, especially intravenously.
Keywords
anaphylaxis; Kounis syndrome; Omeprazole
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[3] Ventura MT, Buquicchio R, Cecere R, Calogiuri G, Cannito CD, De Donno M, et al. Anaphylactic reaction after the concomitant intravenous administration of corticosteroids and gastroprotective drugs: two case reports. J Biol Regul Homeost Agents. 2013;27:589-94.
[4] Galindo PA, Borja J, Feo F, Gómez E, García R, Cabrera M, et al. Anaphylaxis to omeprazole. Ann Allergy Asthma Immunol. 1999;82:52-4. doi: 10.1016/S1081-1206(10)62660-9
[5] Demirkan K, Bozkurt B, Karakaya G, Kalyoncu AF. Anaphylactic reaction to drugs commonly used for gastrointestinal system diseases: 3 case reports and review of the literature. J Investig Allergol Clin Immunol. 2006;16:203-9.
[6] Méndez-Betancourt JL, Ramirez-Ramos CF, Lópes-Guevara OA, Osorio-Carmona HE. Síndrome de Kounies, a propósito de um caso clínico. Acta Méd Perú. 201835;1.
[7] Café HF, Silva BF, Faria AP, Araújo JJ. Pericardite com tamponamento por salmonella enteritidis. Rev Bras Cardiol. 2013;26:142-6.
[8] Aksu K, Kurt E.Anaphylaxis to lansoprazole with tolerance to omeprazole Allergol Immunopathol. 2012;40:393-4.
[9] Almeida JP, Lopes A, Barbosa MPa. Hipersensibilidade a inibidores da bomba de protões: Um caso raro. Rev Port Imunoalergol. 2016 : 31-6.
[10] Abdul Razzak E, Tomás M, Tornero P, Herrero T. Nine cases of allergy to omeprazole. J Investig Allergol Clin Immunol. 2012;22:228-230.
[11] Gázquez V, Dalmau G, Gaig P, Gómez C, Navarro S, Mercé J. Kounis syndrome: report of 5cases. J Investig Allergol Clin Immunol. 2010;20:162-5.
[12] Dueñas-Laita A, Pineda F, Armentia A. Hypersensitivity to generic drugs with soybean oil. N Engl J Med. 2009;361:1317-8. doi: 10.1056/NEJMc0904562
[13] Rodrigues MA, Coelho D, Granja C. Fármacos que podem provocar síndrome de Kounis. Rev Bras Anestesiol. 2013;63:426-8.
[14] Almeida J, Ferreira S, Malheiro J, Fonseca P, Caeiro D, Dias A, et al.. A rare cause of acute coronary syndrome: Kounis syndrome. Rev Port Cardiol. 2016;35:699.e1-699.e4. English, Portuguese. doi: 10.1016/j.repc.2016.03.009.
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