Anaphylactic shock with methylprednisolone, Kounis syndrome and hypersensitivity to corticosteroids: a clinical paradox

摘要: Corticosteroids are widely used for the treatment of allergic reactions but paradoxically themselves may induce acute, delayed, local or systemic and even anaphylaxis with Kounis syndrome. They can suppress release arachidonic acid from mast cell membranes, via phospholipase A2 eicosanoid biosynthesis inhibition. promote apoptosis mediate in annexin lipocortin synthesis, substances that modulate inflammatory activation, adhesion molecule expression, transmigratory phagocytic functions. Antigen-antibody reaction, hapten formation, medication contaminants some incriminated causes. Patients atopic diathesis particularly vulnerable. Complete thorough previous history drug allergies is necessary before administration any particular including corticosteroids.