Two Cardiac Arrests that Occurred after the Administration of Sugammadex: A Case of Kounis Syndrome

Case Reports in Emergency Medicine
Machi Yanai, Koichi Ariyoshi

Abstract

Kounis syndrome is a form of acute coronary syndrome caused by allergic reactions. No cases of cardiac arrest caused by Kounis syndrome that arose after the administration of sugammadex have been reported. A 71-year-old female suffered two cardiac arrests. The first occurred after sugammadex was administered at the end of an operation for a right radial distal fracture. The patient was resuscitated and transferred to our intensive care unit. She was subsequently discharged home. Five months later, she suffered a second cardiac arrest after sugammadex was administered at the end of an operation for a right femoral neck fracture at our hospital. Urgent coronary angiography revealed multiple coronary spasms. Kounis syndrome was diagnosed based on the patient's elevated serum trypsin levels and a positive result in a skin allergy test of sugammadex. In cases of cardiac arrest with unclear etiologies, Kounis syndrome should be considered.

References

May 24, 2012·British Journal of Anaesthesia·K GodaiY Kanmura
Jun 22, 2014·Current Allergy and Asthma Reports·Violeta Régnier GalvãoMariana Castells
Dec 10, 2015·Journal of Anesthesia·Tomonori TakazawaPaul Michel Mertes
Mar 12, 2016·Clinical Chemistry and Laboratory Medicine : CCLM·Nicholas G Kounis
Oct 6, 2016·Korean journal of anesthesiology·Myoung Jin KoJae-Wook Jung
Aug 15, 2017·The Cochrane Database of Systematic Reviews·Ana-Marija HristovskaArash Afshari
Oct 25, 2017·Anesthesia and Analgesia·Yusuke MiyazakiShoichi Uezono
Nov 18, 2017·Journal of Clinical Anesthesia·Shinju ObaraMasahiro Murakawa

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Allergy and Asthma

Allergy and asthma are inflammatory disorders that are triggered by the activation of an allergen-specific regulatory t cell. These t cells become activated when allergens are recognized by allergen-presenting cells. Here is the latest research on allergy and asthma.

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