氯己定与磺达肝癸钠诱发Kounis综合征一例

Chlorhexidine and Fondaparinux-Induced Kounis Syndrome: a Case Report

  • 摘要: Kounis综合征是一种由过敏反应引发的急性冠状动脉综合征,临床少见且易误诊、漏诊。本文报告1例70岁男性患者,于结肠息肉切除术后出现皮疹、瘙痒及胸痛,冠状动脉造影示左前降支闭塞,支架植入术后血流恢复,但症状反复且伴意识丧失。经药物皮肤试验证实其对氯己定及磺达肝癸钠呈阳性反应,诊断为Ⅱ型Kounis综合征。经规避致敏药物并联合抗组胺药及纠正心肌缺血等对症治疗,该例患者的临床症状显著改善并最终康复出院。本病例提示,对于过敏伴胸痛患者应警惕此症,及时识别并规避过敏原。

     

    Abstract: Kounis syndrome is an acute coronary syndrome triggered by an allergic reaction, which is clinically rare and frequently subject to misdiagnosis or missed diagnosis. This article presents a case report of a 70-year-old male patient who developed a rash, pruritus, and chest pain following colon polyp resection. Coronary angiography revealed occlusion of the left anterior descending artery, and blood flow was restored after stent implantation. However, the patient experienced recurrent symptoms accompanied by loss of consciousness. Drug skin tests confirmed positive reactions to chlorhexidine and fondaparinux sodium, leading to a diagnosis of type Ⅱ Kounis syndrome. By avoiding allergenic drugs and combining antihistamines with symptomatic treatment to correct myocardial ischemia, the patient′s clinical symptoms significantly improved, and he eventually recovered and was discharged from the hospital. This case underscores the importance of maintaining vigilance for this syndrome in patients with allergies accompanied by chest pain and promptly identifying and avoiding allergens.

     

/

返回文章
返回