Kounis syndrome is angina or acute coronary syndrome caused by mast cell degranulation and inflammatory cell activation. We present a case of a patient with underlying aspirin-exacerbated respiratory disease (AERD) and previous anaphylaxis to aspirin. The patient underwent aspirin desensitization and was then treated with high-dose aspirin. Unfortunately, he developed recurrent angina and myocardial infarction (MI). Numerous left heart catheterizations revealed vasospasms as the etiology of his MIs; however, therapy with increasing doses of vasodilators yielded no improvement in the patient\'s condition. Ultimately the patient\'s aspirin was discontinued and he had no recurrence of angina or MI.

This review of aspirin-exacerbated respiratory disease (AERD) describes the clinical characteristics and pathophysiology of disease, highlighting its similarities and unique differences in comparison to classic IgE mediated hypersensitivity as well as AERD as a chronic disease. There is a specific focus on the comparison of mediator production over time and the use of desensitization in each diagnosis that serves to aid the clinician in differentiating aspirin reactions in AERD from those related to true immediate hypersensitivity.

暂无摘要。

暂无摘要。