Food-Associated Kounis Syndrome: Clinical Spectrum and Diagnostic Considerations from a Case Report and Systematic Qualitative Synthesis of Published Cases.
Sergio Sanchez-Fernandez, Gabriel Gastaminza Lasarte, Carmen D'Amelio Garófalo et al.
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Case in brief
The supplied abstract does not describe an individual patient’s presentation, diagnostic findings, or outcome. It reports a qualitative synthesis of published food-associated Kounis syndrome cases: 53 patients across 50 reports, with mechanisms including confirmed or suspected food allergy, scombroid poisoning, and a Coprinopsis atramentaria–alcohol interaction. Reported cardiovascular findings ranged from transient vasospasm and nonobstructive presentations to myocardial infarction and coronary, stent, or graft thrombosis. Type I was the most frequently assigned phenotype; assessment and follow-up were inconsistently reported.
What made this case unusual
The synthesis highlights that food-associated coronary events can reflect either allergic Kounis syndrome or non-immune toxic reactions, particularly scombroid poisoning, which may have similar clinical presentations.
Diagnostic / clinical pearl
Assess exposure timing alongside objective cardiovascular findings, coronary substrate, allergological evidence, cofactors, and competing exposures; distinguish suspected allergy from non-immune food-related toxicity.
Why it matters
The abstract cautions that epinephrine preceding a coronary event does not establish that it caused the event; intramuscular epinephrine remains first-line treatment for anaphylaxis.