Kounis syndrome is an acute coronary syndrome associated with mast cell and platelet activation in the setting of allergic or anaphylactic reactions. The mediators released from the same inflammatory cells are also present in acute coronary events of a non-allergic aetiology. There is sufficient evidence about the common pathophysiological pathway between allergic and non-allergic acute coronary syndrome, with mast cells and pro-inflammatory molecules such as histamine, tryptase, chymase, thromboxane, leukotrienes, and IL-6, playing a crucial role. On the other hand, there is no sufficient evidence to support intravenous corticosteroids and/or antihistamines in non-allergic acute coronary syndrome, but further clinical research might be relevant.
Key words: Kounis syndrome, corticosteroids, pathophysiology
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