Durable Polymer Drug Eluting Stent-Induced Kounis Syndrome and Eosinophilia Requiring Long-term Immunosuppression

Can J Cardiol. 2022 Mar;38(3):398-400. doi: 10.1016/j.cjca.2021.12.001. Epub 2021 Dec 10.

Abstract

There are no reports of systemic eosinophilic reactions to durable polymer coated drug eluting stents (DP-DES) and a consensus statement indicates that these devices should be considered in nickel allergy. We present a case of in-stent thrombosis, eosinophilia, and rash consistent with allergic myocardial infarction, a presentation of Kounis syndrome, in the context of metal allergy to DP-DES requiring long-term immunosuppression.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Diagnosis, Differential
  • Drug-Eluting Stents / adverse effects*
  • Eosinophilia* / diagnosis
  • Eosinophilia* / etiology
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Kounis Syndrome* / diagnosis
  • Kounis Syndrome* / drug therapy
  • Kounis Syndrome* / etiology
  • Kounis Syndrome* / physiopathology
  • Male
  • Metals, Heavy / adverse effects
  • Metals, Heavy / analysis
  • Nickel* / adverse effects
  • Nickel* / analysis
  • Non-ST Elevated Myocardial Infarction / surgery
  • Percutaneous Coronary Intervention* / adverse effects
  • Percutaneous Coronary Intervention* / instrumentation
  • Percutaneous Coronary Intervention* / methods
  • Prednisone / administration & dosage*
  • Skin Tests / methods

Substances

  • Immunosuppressive Agents
  • Metals, Heavy
  • Nickel
  • Prednisone