A Complicated Case of Aspirin-Exacerbated Respiratory Disease With Kounis Syndrome

Krista M Shaw; Brittanie I Neaves; Hayden A Springer; Christopher A Coop

doi:10.7759/cureus.45635

A Complicated Case of Aspirin-Exacerbated Respiratory Disease With Kounis Syndrome

Cureus. 2023 Sep 20;15(9):e45635. doi: 10.7759/cureus.45635. eCollection 2023 Sep.

Authors

Krista M Shaw¹, Brittanie I Neaves², Hayden A Springer¹, Christopher A Coop²

Affiliations

¹ Internal Medicine, Keesler Medical Center, Biloxi, USA.
² Allergy and Immunology, Keesler Medical Center, Biloxi, USA.

Abstract

Kounis syndrome is angina or acute coronary syndrome caused by mast cell degranulation and inflammatory cell activation. We present a case of a patient with underlying aspirin-exacerbated respiratory disease (AERD) and previous anaphylaxis to aspirin. The patient underwent aspirin desensitization and was then treated with high-dose aspirin. Unfortunately, he developed recurrent angina and myocardial infarction (MI). Numerous left heart catheterizations revealed vasospasms as the etiology of his MIs; however, therapy with increasing doses of vasodilators yielded no improvement in the patient's condition. Ultimately the patient's aspirin was discontinued and he had no recurrence of angina or MI.

Keywords: aerd; allergic acute coronary syndrome; allergic myocardial infarction; aspirin hypersensitivity; aspirin-exacerbated respiratory disease; kounis syndrome.

Publication types

Case Reports