Professional paper
Be careful what you eat and drink; Coprinic and Kounis syndrome in a patient with the Samter`s triad
Joaquín Valle Alonso
; Department of Emergency Medicine Southport and Ormskirk Hospital NHS Trust Town Lane, Southport, Merseyside, PR8 6PN; Department of Emergency Medicine, Hospital Valle de los Pedroches, Pozoblanco, Córdoba, Spain
Carmen Navarro
; Department of Cardiology, Hospital Valle de los pedroches, Pozoblanco, Córdoba, Spain
Elisa Lopera
; Department of Emergency Medicine, Hospital Valle de los Pedroches, Pozoblanco, Córdoba, Spain
Yelda Hernández Montes
; Department of Emergency Medicine, Hospital Valle de los Pedroches, Pozoblanco, Córdoba, Spain
Pedro Ceballos García
; Department of Emergency Medicine, Hospital Valle de los Pedroches, Pozoblanco, Córdoba, Spain
José Tejeda
; Department of Emergency Medicine, Hospital Valle de los Pedroches, Pozoblanco, Córdoba, Spain
Abstract
Allergic reactions to chemicals, food products or even insect bites are encountered all over the world with a variety of manifestations. Symptoms range from the development of a minor rash to life threatening anaphylactic reactions. Sometimes, acute coronary syndrome (ACS) can be registered in such patients, which may have a serious impact on the course and management of the allergic reaction. Mushroom poisoning constitutes the main portion of plant toxicities in Spain. Depending on the type of mushroom, the adverse effects range from mild gastrointestinal (GI) symptoms to major cytotoxic effects resulting in organ failure and death. Coprinopsis atramentaria poisoning is rare but with serious consequences. We report a case of a 27 year old patient with a previous history of mild persistent asthma, nasal polyps and aspirin allergy that arrived to the Emergency Department with dizziness and temor after consuming beer at a party. On arrival to the hospital, the patient suddenly collapsed, with an electrocardiogram (ECG) showing ST elevation in the inferior leads and 3rd degree atrioventricular (AV) block accompanied by urticarial-like lesions. After administration of treatment, the patient and ECG abnormalities improved. A detailed medical history showed that the patient had eaten scrambled mushrooms and beer. Expert analysis demonstrated that the combined consumption of Coprinopsis atramentaria and alcoholic beverages produced a disulfiram-like reaction (Coprinic syndrome) and type I Kounis syndrome. No case like this has been previously reported.
Keywords
Kounis syndrome; Coreopsis atramentaria; acute coronary syndrome
Hrčak ID:
140732
URI
Publication date:
1.4.2015.
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