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Foti Randazzese S, Caminiti L, Crisafulli G, Giovannini M, Kounis NG, Manti S. Kounis syndrome in an adolescent with lipid transfer protein allergy. Pediatr Allergy Immunol 2024; 35:e14239. [PMID: 39244678 DOI: 10.1111/pai.14239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 08/24/2024] [Accepted: 08/29/2024] [Indexed: 09/10/2024]
Affiliation(s)
- Simone Foti Randazzese
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Lucia Caminiti
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Giuseppe Crisafulli
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Sara Manti
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
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2
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Mori F, Saretta F, Giovannini M, Gelsomino M, Liotti L, Barni S, Mastrorilli C, Pecoraro L, Castagnoli R, Arasi S, Caminiti L, Klain A, Miraglia Del Giudice M, Novembre E. Pediatric idiopathic anaphylaxis: practical management from infants to adolescents. Ital J Pediatr 2024; 50:145. [PMID: 39118168 PMCID: PMC11311942 DOI: 10.1186/s13052-024-01712-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 07/20/2024] [Indexed: 08/10/2024] Open
Abstract
Idiopathic anaphylaxis (IA) remains a frustrating challenge for both patients and physicians. The aim of this paper is to focus on IA in pediatric ages and suggest possible diagnostic algorithms according to specific age ranges (infants, children, and adolescents). In fact, in a variable percentage of patients, despite extensive diagnostic tests, the cause of anaphylactic episodes cannot be identified. Moreover, the lack of a unanimous IA definition requires a careful and detailed diagnostic workup. Prompt recognition of signs and symptoms, especially in younger children, and an accurate clinical history often allow a choice of the most appropriate diagnostic tests and a correct differential diagnosis.
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Affiliation(s)
- Francesca Mori
- Allergy Unit, Meyer Children's Hospital IRCCS, Florence, 50139, Italy
| | - Francesca Saretta
- Pediatric Department, General Pediatrician, Azienda Sanitaria Universitaria Friuli Centrale, Udine, 33100, Italy
| | - Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital IRCCS, Florence, 50139, Italy
- Department of Health Sciences, University of Florence, Florence, 50139, Italy
| | - Mariannita Gelsomino
- Department of Life Sciences and Public Health, Pediatric Allergy Unit, University Foundation Policlinico Gemelli IRCCS Catholic University of the Sacred Heart Rome, Rome, Italy.
| | - Lucia Liotti
- Department of Mother and Child Health, Pediatric Unit, Salesi Children's Hospital, Ancona, 60123, Italy
| | - Simona Barni
- Allergy Unit, Meyer Children's Hospital IRCCS, Florence, 50139, Italy
| | - Carla Mastrorilli
- Pediatric and Emergency Department, Pediatric Hospital Giovanni XXIII, AOU Policlinic of Bari, Bari, 70126, Italy
| | - Luca Pecoraro
- Pediatric Unit, Department of Surgical Sciences, Destiny, Gynecology and Pediatrics, University of Verona, Verona, 37126, Italy
| | - Riccardo Castagnoli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, 27100, Italy
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, 27100, Italy
| | - Stefania Arasi
- Division of Allergy, Translational Research in Pediatric Specialties Area, Bambino Gesù Children's Hospital, IRCCS, Rome, 00165, Italy
| | - Lucia Caminiti
- Allergy Unit, Department of Pediatrics, AOU Policlinico Gaetano Martino, Messina, 98124, Italy
| | - Angela Klain
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, 80138, Italy
| | - Michele Miraglia Del Giudice
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, 80138, Italy
| | - Elio Novembre
- Department of Health Sciences, University of Florence, Florence, 50139, Italy
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3
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Granda P, Villamañán E, Laorden D, Carpio C, Collada V, Domínguez-Ortega J, de las Vecillas L, Romero-Ribate D, Chaparro-Díaz OF, Lázaro Miguel-Sin T, Alloca-Álvarez DJ, Correa-Borit JM, Losantos I, Mir-Ihara P, Narváez-Fernández EJ, Quirce S, Álvarez-Sala R. Cardiovascular Events in Patients with Severe Asthma-A Retrospective Study of Two Cohorts: Asthma Type T2 Treated with Biologics and Non-Type T2. J Clin Med 2024; 13:4299. [PMID: 39124568 PMCID: PMC11313306 DOI: 10.3390/jcm13154299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 08/12/2024] Open
Abstract
Background: The prevalence of cardiovascular events (CVEs) in patients with asthma varies amongst studies, with little evidence as to their prevalence in patients treated with monoclonal antibodies (mAbs). In this retrospective, observational study, we aimed to evaluate the prevalence of CVEs in patients with T2 and non-T2 asthma and to identify risk factors associated with CVEs. Methods: A total of 206 patients with severe asthma were included. Demographic variables, respiratory comorbidities and cardiovascular risk factors were collected, along with respiratory function, laboratory parameters and respiratory pharmacotherapy, including treatment with mAbs. Results: A total of 10.7% of the patients had any CVE from the date of asthma diagnosis, with a higher risk in those patients with chronic obstructive pulmonary disease (odds ratio [OR] = 5.36, 95% CI 1.76-16.31; p = 0.003), arterial hypertension (OR = 2.71, 95% CI 1.13-6.55; p = 0.026) and dyslipidaemia (OR = 9.34, 95% CI 3.57-24.44; p < 0.001). No association between mAb treatment and a CVE or between time of mAb treatment and the event was found. No significant differences were observed between the T2 and non-T2 cohort. After a multivariate analysis, dyslipidaemia was identified as an independent risk factor (OR = 13.33, 95% CI 4.49-39.58; p < 0.001), whereas regular use of inhaled corticosteroids was associated with a reduced risk of a CVE (OR = 0.103, 95% CI 0.021-0.499; p = 0.005). Further research is needed to fully understand the relationship between severe asthma and CVEs. Conclusions: This study suggests that patients with severe asthma experience a higher percentage of CVEs compared with the general population.
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Affiliation(s)
- Paula Granda
- Pharmacy Department, Gómez Ulla Military Hospital, 28047 Madrid, Spain
| | - Elena Villamañán
- Pharmacy Department, La Paz University Hospital, IdiPAZ, 28029 Madrid, Spain; (E.V.); (V.C.)
- Medicine Department, Autonomous University of Madrid, 28049 Madrid, Spain; (C.C.); (R.Á.-S.)
| | - Daniel Laorden
- Pneumology Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, Spain; (D.L.); (D.R.-R.); (O.F.C.-D.); (T.L.M.-S.); (D.J.A.-Á.)
| | - Carlos Carpio
- Medicine Department, Autonomous University of Madrid, 28049 Madrid, Spain; (C.C.); (R.Á.-S.)
- Pneumology Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, Spain; (D.L.); (D.R.-R.); (O.F.C.-D.); (T.L.M.-S.); (D.J.A.-Á.)
| | - Victoria Collada
- Pharmacy Department, La Paz University Hospital, IdiPAZ, 28029 Madrid, Spain; (E.V.); (V.C.)
| | - Javier Domínguez-Ortega
- Allergy Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, Spain; (J.D.-O.); (L.d.l.V.); (J.M.C.-B.); (P.M.-I.); (E.J.N.-F.); (S.Q.)
| | - Leticia de las Vecillas
- Allergy Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, Spain; (J.D.-O.); (L.d.l.V.); (J.M.C.-B.); (P.M.-I.); (E.J.N.-F.); (S.Q.)
| | - David Romero-Ribate
- Pneumology Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, Spain; (D.L.); (D.R.-R.); (O.F.C.-D.); (T.L.M.-S.); (D.J.A.-Á.)
| | - Omar Fabián Chaparro-Díaz
- Pneumology Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, Spain; (D.L.); (D.R.-R.); (O.F.C.-D.); (T.L.M.-S.); (D.J.A.-Á.)
| | - Teresa Lázaro Miguel-Sin
- Pneumology Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, Spain; (D.L.); (D.R.-R.); (O.F.C.-D.); (T.L.M.-S.); (D.J.A.-Á.)
| | - Daniela Jose Alloca-Álvarez
- Pneumology Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, Spain; (D.L.); (D.R.-R.); (O.F.C.-D.); (T.L.M.-S.); (D.J.A.-Á.)
| | - Jorge Mauricio Correa-Borit
- Allergy Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, Spain; (J.D.-O.); (L.d.l.V.); (J.M.C.-B.); (P.M.-I.); (E.J.N.-F.); (S.Q.)
| | - Itsaso Losantos
- Biostatistics Department, La Paz University Hospital, 28046 Madrid, Spain;
| | - Patricia Mir-Ihara
- Allergy Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, Spain; (J.D.-O.); (L.d.l.V.); (J.M.C.-B.); (P.M.-I.); (E.J.N.-F.); (S.Q.)
| | - Emilio José Narváez-Fernández
- Allergy Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, Spain; (J.D.-O.); (L.d.l.V.); (J.M.C.-B.); (P.M.-I.); (E.J.N.-F.); (S.Q.)
| | - Santiago Quirce
- Allergy Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, Spain; (J.D.-O.); (L.d.l.V.); (J.M.C.-B.); (P.M.-I.); (E.J.N.-F.); (S.Q.)
| | - Rodolfo Álvarez-Sala
- Medicine Department, Autonomous University of Madrid, 28049 Madrid, Spain; (C.C.); (R.Á.-S.)
- Pneumology Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, Spain; (D.L.); (D.R.-R.); (O.F.C.-D.); (T.L.M.-S.); (D.J.A.-Á.)
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Tang C, Chen Y, Gu X. Case Report: Flurbiprofen-induced Type I Kounis syndrome. Front Cardiovasc Med 2023; 10:1284408. [PMID: 38054095 PMCID: PMC10694269 DOI: 10.3389/fcvm.2023.1284408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/30/2023] [Indexed: 12/07/2023] Open
Abstract
Background Kounis syndrome is a specific type of acute coronary syndrome caused by allergic or hypersensitivity response. Clinical knowledge about this syndrome is insufficient. We report a case in which intravenous administration of flurbiprofen resulted in Type I Kounis syndrome. Case summary A 60-year-old female patient with no history of coronary artery disease developed limb erythema, hypotension, and chest tightness after receiving intravenous flurbiprofen. Electrocardiogram showed ST segment elevation in leads II, III, and aVF. Emergency coronary angiography revealed no significant stenosis or thrombus in the coronary arteries. Subsequent echocardiography showed no apparent abnormalities. Levels of troponin T were elevated. The diagnosis was flurbiprofen-induced Type I Kounis syndrome, presenting as acute ST segment elevation myocardial infarction. Conclusions Patients with Kounis syndrome can exhibit severe clinical symptoms, and their condition may even be life-threatening. It is important for clinicians to have a thorough understanding of this syndrome in order to develop comprehensive treatment plans.
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Affiliation(s)
| | | | - Xiaosong Gu
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
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5
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Abstract
Kounis syndrome is the concurrence of acute coronary syndrome or coronary vasospasm with conditions associated with the release of inflammatory cytokines through mast cell activation in the setting of allergic or anaphylactic reactions. Many identified triggers have been identified in paediatric patients including exposures, drugs, and immunisations; however, to our knowledge this is the first case report of Kounis syndrome linked to immunotherapy. We present a case of a 9-year-old with seasonal allergies presenting with clinical symptoms of Kounis syndrome following her weekly subcutaneous injection of allergens. Clinicians need a high index of suspicion for Kounis syndrome in patients who develop systemic signs of anaphylaxis with clinical, laboratory, electrocardiographic, and echocardiographic findings of acute coronary syndrome to help direct therapy and improve outcomes.
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6
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Al Hajri HS, El Husseiny EM, Qayyum H. Chest Pain and Electrocardiographic Changes in a Child With Duchenne Muscular Dystrophy. Cureus 2022; 14:e26105. [PMID: 35747106 PMCID: PMC9207991 DOI: 10.7759/cureus.26105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 11/12/2022] Open
Abstract
A 12-year-old boy known to have Duchenne muscular dystrophy presented to our Emergency Department with acute onset central chest pain. A 12-lead electrocardiogram (ECG) was performed showing ST-segment elevation with reciprocal changes. An echocardiogram showed reduced left ventricular systolic function with an ejection fraction of 45%. Initial cardiac biomarkers were significantly elevated, with troponin-T result recorded at 7,065 ng/L (reference range: 0-14 ng/L). The patient was admitted to the pediatric intensive care unit with a differential diagnosis of acute myocardial infarction or acute myocardial injury related to cardiomyopathy and commenced on an ACE (angiotensin-converting enzyme) inhibitor. Computed tomography (CT) of the coronary arteries was performed, which showed normal coronary arteries and cardiac anatomy. The patient was discharged on day 5 and continues to follow up in the pediatric cardiology clinic. He was commenced on a beta blocker at one-month follow-up when he was asymptomatic.
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Castagnoli R, Giovannini M, Mori F, Barni S, Pecoraro L, Arasi S, Saretta F, Mastrorilli C, Liotti L, Caminiti L, Sturm GJ, Marseglia GL, Novembre E. Unusual Reactions to Hymenoptera Stings: Current Knowledge and Unmet Needs in the Pediatric Population. Front Med (Lausanne) 2021; 8:717290. [PMID: 34901051 PMCID: PMC8661053 DOI: 10.3389/fmed.2021.717290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 10/27/2021] [Indexed: 11/13/2022] Open
Abstract
Hymenoptera stings are generally well-tolerated and usually cause limited local reactions, characterized by self-resolving erythema and edema associated with pain. However, Hymenoptera stings can induce immediate and delayed hypersensitivity reactions. In addition to these manifestations, unusual reactions to Hymenoptera stings have been reported. The latter are defined as unusual because of their atypical characteristics. They may differ from classical hypersensitivity reactions due to the stings' particular localization and the unusual involvement of one or more specific organs. Although unusual reactions to Hymenoptera stings are infrequent, it is essential for clinicians to know the possible related clinical manifestations. Here, we review the available literature and propose a diagnostic and management algorithm. At present, there are no defined guidelines for most of the unusual reactions to Hymenoptera stings, which should be managed in a tailored way according to the specifical clinical manifestations presented by the patients. Further studies are needed to better define these conditions and the underlying pathogenetic mechanisms to improve the diagnostic and therapeutic approach.
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Affiliation(s)
- Riccardo Castagnoli
- Department of Pediatrics, Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Mattia Giovannini
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Francesca Mori
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Simona Barni
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Luca Pecoraro
- Department of Medicine, University of Verona, Policlinico GB Rossi, Verona, Italy.,Pediatric Unit, ASST Mantua, Mantua, Italy
| | - Stefania Arasi
- Translational Research in Pediatric Specialities Area, Division of Allergy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesca Saretta
- Pediatric Department, Latisana-Palmanova Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Carla Mastrorilli
- Pediatric Unit and Emergency, University Hospital Consortium Corporation Polyclinic of Bari, Pediatric Hospital Giovanni XXIII, Bari, Italy
| | - Lucia Liotti
- Department of Pediatrics, Salesi Children's Hospital, AOU Ospedali Riuniti Ancona, Ancona, Italy
| | - Lucia Caminiti
- Department of Human Pathology in Adult and Development Age "Gaetano Barresi," Allergy Unit, Department of Pediatrics, AOU Policlinico Gaetano Martino, Messina, Italy
| | - Gunter Johannes Sturm
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria.,Allergy Outpatient Clinic Reumannplatz, Vienna, Austria
| | - Gian Luigi Marseglia
- Department of Pediatrics, Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Elio Novembre
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
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8
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Di Filippo C, Giovannini M, Gentile S, Mori F, Porcedda G, Manfredi M, Calabri GB, De Simone L, Favilli S, Kounis NG. Kounis Syndrome Associated With Takotsubo Syndrome in an Adolescent With Peutz-Jeghers Syndrome. JACC Case Rep 2021; 3:1602-1606. [PMID: 34729510 PMCID: PMC8543138 DOI: 10.1016/j.jaccas.2021.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/07/2021] [Accepted: 07/13/2021] [Indexed: 12/02/2022]
Abstract
We describe the case of a 15-year-old female patient with Peutz-Jeghers syndrome who presented with vomiting and abdominal pain secondary to ileoileal invagination. Initial analgesic treatment was not effective, and subsequent tramadol infusion resulted in clinical manifestations compatible with Kounis and Takotsubo syndromes. However, the patient had an excellent recovery. (Level of Difficulty: Advanced.)
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Affiliation(s)
- Chiara Di Filippo
- Cardiology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Mattia Giovannini
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Silvia Gentile
- Cardiology Unit, Santa Maria Nuova Hospital, Florence, Italy
| | - Francesca Mori
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Giulio Porcedda
- Cardiology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Mariangela Manfredi
- Immunology and Allergy Laboratory, San Giovanni di Dio Hospital, Florence, Italy
| | | | - Luciano De Simone
- Cardiology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Silvia Favilli
- Cardiology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
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9
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Capponi G, Giovannini M, Koniari I, Mori F, Rubino C, Spaziani G, Calabri GB, Favilli S, Novembre E, Indolfi G, De Simone L, Trapani S. Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital Glaucoma. Front Cardiovasc Med 2021; 8:676188. [PMID: 34568441 PMCID: PMC8461009 DOI: 10.3389/fcvm.2021.676188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/13/2021] [Indexed: 11/13/2022] Open
Abstract
A 12-year-old male patient suffering from congenital glaucoma developed bradycardia, left ventricular failure, and hypotension after induction of anesthesia. Electrocardiography and echocardiography revealed a complete normalization of ECG and a complete spontaneous recovery in the cardiac function 72 hours from the beginning of the clinical manifestations, while cardiac Magnetic Resonance Imaging was performed, and coronary Computed Tomography scan revealed a myocardial bridge of a tract of the left anterior descendent coronary artery. Diagnosis of Kounis syndrome (KS) was made, a relatively novel, under-recognized clinical condition, defined as the manifestation of an acute coronary syndrome accompanied by mast cell activation and platelet aggregation involving interrelated and interacting inflammatory cells in the setting of allergic, hypersensitivity, anaphylactic or anaphylactoid insults. We described one of the first pediatric cases of KS related to anesthetic medications. In children, this syndrome has been only described in isolated case reports or small case series. Thus, it appears critical to report new cases of KS in children to increase the awareness of this disease in pediatric healthcare workers so as to enhance its early recognition and optimal therapeutic strategy. Furthermore, it appears of paramount importance the implementation of universal guidelines accepted by allergology and cardiology societies, in order to standardize the management of pediatric and adult patients with KS. Finally, a close collaboration between pediatric allergists and cardiologists seems fundamental for an optimal multidisciplinary patient care.
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Affiliation(s)
- Guglielmo Capponi
- Cardiology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Mattia Giovannini
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Ioanna Koniari
- Electrophysiology and Device Department, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom
| | - Francesca Mori
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Chiara Rubino
- Department of Pediatrics, Meyer Children's Hospital, Florence, Italy
| | - Gaia Spaziani
- Cardiology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | | | - Silvia Favilli
- Cardiology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Elio Novembre
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Giuseppe Indolfi
- Department of Pediatrics, Meyer Children's Hospital, Florence, Italy.,Department of NEUROFARBA, Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Luciano De Simone
- Cardiology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Sandra Trapani
- Department of Pediatrics, Meyer Children's Hospital, Florence, Italy.,Department of Health Sciences, Meyer Children's Hospital, University of Florence, Florence, Italy
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10
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Bodur İ, Yaradılmış RM, Güngör A, Sel K, Tuygun N. A rare pediatric case of Kounis syndrome after bee sting. Acta Clin Belg 2021; 77:782-784. [PMID: 34556004 DOI: 10.1080/17843286.2021.1981587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- İlknur Bodur
- Department of Pediatric Emergency Care, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Raziye Merve Yaradılmış
- Department of Pediatric Emergency Care, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Ali Güngör
- Department of Pediatric Emergency Care, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Kutay Sel
- Department of Pediatric Cardiology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Nilden Tuygun
- Department of Pediatric Emergency Care, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
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11
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Giovannini M, Koniari I, Mori F, Barni S, Novembre E, Kounis NG. Reply to the letter: "Kounis syndrome: Towards a new classification". Int J Cardiol 2021; 339:19-20. [PMID: 34048857 DOI: 10.1016/j.ijcard.2021.05.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 05/21/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Mattia Giovannini
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy.
| | - Ioanna Koniari
- Electrophysiology and Device Department University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom.
| | - Francesca Mori
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy.
| | - Simona Barni
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy.
| | - Elio Novembre
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy.
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12
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Giovannini M, Koniari I, Mori F, Barni S, Novembre E, Kounis NG. Kounis syndrome: Towards a new classification. Int J Cardiol 2021; 341:13-14. [PMID: 33848557 DOI: 10.1016/j.ijcard.2021.04.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 04/07/2021] [Indexed: 01/03/2023]
Affiliation(s)
- Mattia Giovannini
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy.
| | - Ioanna Koniari
- Electrophysiology and Device Department, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom.
| | - Francesca Mori
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy.
| | - Simona Barni
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy.
| | - Elio Novembre
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy.
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