Blood Transfusion Components Inducing Severe Allergic Reactions: The First Case of Kounis Syndrome Induced by Platelet Transfusion

被引:2
|
作者
Gogos, Christos [1 ]
Stamos, Konstantinos [1 ]
Tsanaxidis, Nikolaos [1 ]
Styliadis, Ioannis [1 ]
Koniari, Ioanna [2 ]
Kouni, Sophia N. N. [3 ]
de Gregorio, Cesare [4 ]
Kounis, Nicholas G. G. [5 ]
机构
[1] Papageorgiou Gen Hosp, Dept Cardiol, Thessaloniki 56403, Greece
[2] Liverpool Heart & Chest Hosp, Dept Cardiol, Liverpool L14 3PE, England
[3] Speech Therapy Practice, Patras 26221, Greece
[4] Univ Messina, Med Sch, Dept Clin & Expt Med, I-98122 Messina, Italy
[5] Univ Patras, Dept Internal Med, Med Sch, Div Cardiol, Patras 26221, Greece
关键词
allergy; anaphylaxis; blood transfusion; blood components; Kounis syndrome; platelets; transfusion; FC-EPSILON-RI; ANAPHYLACTIC REACTION; IGE; PATHOGENESIS; RELEASE; PATIENT;
D O I
10.3390/vaccines11020220
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Kounis syndrome is a multisystem and multidisciplinary disease affecting the circulatory system that can be manifested as spasm and thrombosis. It can occur as allergic, hypersensitivity, anaphylactic, or anaphylactoid reactions associated with the release of inflammatory mediators from mast cells and from other interrelated and interacting inflammatory cells, including macrophages and lymphocytes. A platelet subset with high- and low-affinity IgE surface receptors is also involved in this process. Whereas the heart, and particularly the coronary arteries, constitute the primary targets of inflammatory mediators, the mesenteric, cerebral, and peripheral arteries are also vulnerable. Kounis syndrome is caused by a variety of factors, including drugs, foods, environmental exposure, clinical conditions, stent implantation, and vaccines. We report a unique case of a 60-year-old male with a past medical history of allergy to human albumin, alcoholic cirrhosis, and esophageal varices, who was admitted due to multiple episodes of hematemesis. Due to low hemoglobin levels, he was transfused with 3 units of red blood cells and fresh frozen plasma without any adverse reactions. On the third day of hospitalization, severe thrombocytopenia was observed and transfusion of platelets was initiated. Immediately following platelet infusion, the patient developed chest discomfort, skin signs of severe allergic reaction, and hemodynamic instability. The electrocardiogram revealed ST segment elevation in the inferior leads. Given the strong suspicion of Kounis syndrome/allergic coronary spasm, the patient was treated with anti-allergic treatment only, without any anti-platelet therapy. The clinical status of the patient gradually improved and the electrocardiographic changes reverted to normal. Based on these findings, Kounis hypersensitivity-associated acute coronary syndrome, specifically, type I Kounis syndrome, was diagnosed. Although platelet transfusion can be a life-saving therapy, each blood transfusion carries a substantial risk of adverse reactions. The aims of this report are to expand the existing knowledge of patient responses to blood transfusion and provide information on the incidence of various severe transfusion reactions to all blood components and especially to platelets. To the best of our knowledge, Kounis syndrome induced by platelet transfusionhas never been previously reported. Hypersensitivity to platelet external membrane glycoproteins in an atopic patient seems to be the possible etiology. Despite that Kounis syndrome remains an under-diagnosed clinical entity in everyday practice, it should always be considered in the differential diagnosis of acute coronary syndromes.
引用
收藏
页数:10
相关论文
共 47 条
  • [31] The BEST criteria improve sensitivity for detecting positive cultures in residual blood components cultured in suspected septic transfusion reactions
    Shih, Andrew W.
    Cohn, Claudia S.
    Delaney, Meghan
    Fontaine, Magali J.
    Martin, Isabella
    Dunbar, Nancy M.
    Dagger, John
    Fadeyi, Emmanuel A.
    Flanagan, Peter
    Gathof, Birgit
    Godbey, Elizabeth A.
    Harach, Mary
    Huggins, Y. Monique
    Ipe, Tina S.
    Jackson, Bryon
    Jacquot, Cyril
    Jin, Zhongbo
    Jones, Mary Rose
    Kamel, Hany
    Karp, Julie K.
    Lewin, Antoine
    Mo, Yunchuan
    Murphy, Mike
    O'Brien, Jennifer
    Ommer, Katharina
    Pagano, Monica B.
    Passwater, Michael
    Pelletier, J. Peter R.
    Robillard, Pierre
    Schwartz, Joseph
    Sham, Lawrence
    Shunkwiler, Sara M.
    Simmons, Julie S.
    Staves, Julie
    Takanaski, Minoko
    Vasallo, Ralph
    Weiss, Susan
    Williams, Shelly M.
    Yamada, Chisa
    Young, Pampee P.
    Ziman, Alyssa
    TRANSFUSION, 2019, 59 (07) : 2292 - 2300
  • [32] Reversible cerebral vasoconstriction syndrome following red blood cells transfusion: a case series of 7 patients
    Liang, Hui
    Xu, Ziqi
    Zheng, Zhijun
    Lou, Haiyan
    Yue, Wei
    ORPHANET JOURNAL OF RARE DISEASES, 2015, 10
  • [33] Reversible cerebral vasoconstriction syndrome following red blood cells transfusion: a case series of 7 patients
    Hui Liang
    Ziqi Xu
    Zhijun Zheng
    Haiyan Lou
    Wei Yue
    Orphanet Journal of Rare Diseases, 10
  • [34] Relationship between packed red blood cell transfusion and severe form of necrotizing enterocolitis: A case control study
    Garg, Parvesh M.
    Ravisankar, Srikanth
    Bian, Hui
    Macgilvray, Scott
    Shekhawat, Prem S.
    INDIAN PEDIATRICS, 2015, 52 (12) : 1041 - 1045
  • [35] Relationship between packed red blood cell transfusion and severe form of necrotizing enterocolitis: A case control study
    Parvesh M. Garg
    Srikanth Ravisankar
    Hui Bian
    Scott Macgilvray
    Prem S. Shekhawat
    Indian Pediatrics, 2015, 52 : 1041 - 1045
  • [36] Sirolimus alternative to blood transfusion as a life saver in blue rubber bleb nevus syndrome A case report
    Wang, Ke-Ling
    Ma, Shu-Fang
    Pang, Ling-Yu
    Zhang, Meng-Na
    Hu, Lin-Yan
    Liu, Meng-Jia
    Zou, Li-Ping
    MEDICINE, 2018, 97 (08)
  • [37] Posterior reversible encephalopathy syndrome in a known case of beta-thalassemia major after blood transfusion: a case presentation
    Hanna, Diana
    Nada, Mohamad Gamal
    Gohary, Mahmoud M.
    EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE, 2024, 72 (01)
  • [38] Risk of transfusion-transmitted infection with severe acute respiratory syndrome coronavirus 2 from blood donors in Japan
    Shinohara, Naoya
    Ito, Mai
    Kai, Kazuhiro
    Kamo, Noriyuki
    Owada, Takashi
    Sobata, Rieko
    Yamagishi, Naoji
    Takahashi, Hideyuki
    Ikeda, Yohei
    Sawai, Hiromi
    Furuta, Rika A.
    Matsubayashi, Keiji
    Hino, Ikuo
    Goto, Naoko
    Satake, Masahiro
    TRANSFUSION, 2024, 64 (01) : 116 - 123
  • [39] Evaluation of Risk Minimisation Measures for Blood Components - Based on Reporting Rates of Transfusion-Transmitted Reactions (1997-2013)
    Funk, Markus B.
    Heiden, Margarethe
    Volkers, Peter
    Lohmann, Annette
    Keller-Stanislawski, Brigitte
    TRANSFUSION MEDICINE AND HEMOTHERAPY, 2015, 42 (04) : 240 - 246
  • [40] Transfusion-associated adverse reactions (TAARs) and cytokine accumulations in the stored blood components: the impact of prestorage versus poststorage leukoreduction
    Chang, Chih-Chun
    Lee, Tai-Chen
    Su, Ming-Jang
    Lin, Hsiu-Chen
    Cheng, Fang-Yi
    Chen, Yi-Ting
    Yen, Tzung-Hai
    Chu, Fang-Yeh
    ONCOTARGET, 2018, 9 (04): : 4385 - 4394