Kounis Syndrome Accompanying Diffuse Alveolar Hemorrhage due to Pinaverium Bromide: A Case Report

Öz

Kounis syndrome is defined as a coronary artery distortion due to hypersensitivity to various reasons such as drugs, environmental exposure, nutrients, coronary stents, etc. Diffuse alveolar hemorrhage is a life-threatening condition that clinically presents with hypoxemic respiratory distress, low hematocrit level, hemoptysis, and extensive pulmonary infiltration. Drugs involving pinaverium bromide as an active ingredient is frequently used for relieving gastrointestinal complaints. In this report, we present a case of a young female patient with Kounis syndrome accompanying diffuse alveolar hemorrhage admitted to our emergency department due to allergic reaction following Pinaverium Bromide intake.

Anahtar Kelimeler

• Anaphylaxis
• diffuse alveolar hemorrhage
• Kounis Syndrome
• Pinaverium Bromide

Pinaverium Bromide Bağlı Diffüz Alveoler Hemorajiye Eşlik Eden Kounis Sendromu: Olgu Sunumu

Öz

Kounis sendromu, çeşitli nedenlere bağlı olarak koroner arter bozulması olarak tanımlanır. Bu nedenler arasında ilaçlar, çevresel maruziyetler, besinler, koroner stentler vb. yer alabilir. Diffüz alveoler hemoraji hipoksemik solunum sıkıntısı, düşük hematokrit seviyesi, hemoptizi ve geniş pulmoner infiltrasyon ile klinik olarak kendini gösteren hayatı tehdit eden bir durumdur. Pinaverium bromid etken maddesi içeren ilaçlar sıklıkla gastrointestinal şikayetlerin hafifletilmesi için kullanılır. Bu raporda, Pinaverium bromid alımını takiben alerjik reaksiyon nedeniyle Acil Servisimize başvuran ve Kounis sendromu ile birlikte diffüz alveoler hemorajiye sahip genç bir kadın hastayı sunuyoruz.

Anahtar Kelimeler

• Anafilaksi
• diffüz alveolar hemoraji
• Kounis Sendromu
• Pinaverium Bromid

Kaynakça

1. Kounis NG. Kounis syndrome: an update on epidemiology, pathogenesis, diagnosis and therapeutic management. Clin Chem Lab Med 2016;54(10):1545-1559.
2. Raschi E, Fertonani Affini L, Antonazzo IC, Diemberger I, Poluzzi E, De Ponti F. Drug-induced Kounis syndrome: A matter of pharmacovigilance. Int J Cardiol 2019;274:381.
3. Ece Y, Erenler AK, Doğan T. Kounis Syndrome following metamizole infusion. Sakarya Med J 2016;6:170-174.
4. Newsome BR, Morales JE. Diffuse alveolar hemorrhage. South Med J 2011;104(4):269-274.
5. Ioachimescu OC, Stoller JK. Diffuse alveolar hemorrhage: diagnosing it and finding the cause. Cleve Clin J Med 2008;75(4):258-280.
6. Bor S, Lehert P, Chalbaud A, Tack J. Efficacy of pinaverium bromide in the treatment of irritable bowel syndrome: a systematic review and meta-analysis. Therap Adv Gastroenterol 2021;14:17562848211033740.
7. Tsigkas G, Chouchoulis K, Theodoropoulos K, Kounis NG, Alexopoulos D. Allergic reaction reveals a non-lethal late stent thrombosis. A new subtype of Kounis syndrome?. Int J Cardiol 2011;149(2):281-282.