DİKLOFENAK POTASYUMUN ORAL ALIMINA BAĞLI KOUNİS SENDROMU: OLGU SUNUMU Kounis Syndrome Due to Oral Intake of Diclofenac Potassium: A case report

OZET Allerjik reaksiyonlar, koroner spazm, akut stent trombozu veya inflamatuar sitokinlerin salinmasi sonucu koroner plak rupturu yoluyla akut koroner sendroma neden olabilirler. Bu klinik antite Kounis Sendromu olarak adlandirilir. 64 yasinda erkek hasta gogus agrisi, nefes darligi, bulanti ve kusma sikayetleri ile hastanemiz acil servisine basvurdu. Basvuru oncesinde bas agrisi icin oral yolla diklofenak kullandigi tespit edildi. Elektrokardiyografisinde(EKG) lateral derivasyonlarda STsegment yukselmesi izlendi. Acil koroner anjiyografide koroner damarlar normaldi. Hastaya anafilaktik reaksiyon teshisi kondu. Anafilaksi basariyla tedavi edildikten sonra, ST-segment yukselmeleri cozuldu. Klinisyenler bu sendromun hizli tani ve uygun tedavi icin farkinda olmalidir. Anahtar Sozcu¨kler: Kounis sendromu; Anafilaksi; Diklofenak potasyum ABSTRACT Allergic reactions may cause acute coronary syndrome by coronary spasm, acute stent thrombosis or coronary plaque rupture via releasing of inflammatory cytokines. This clinical entity is termed as Kounis Syndrome. We encountered a 64-year-old male who admitted to emergency department of our hospital with complaints of chest pain, shortness of breath, nausea and vomiting. Before the application, it was found that he used diclofenac orally for headache. His electrocardiography(ECG) showed ST-segment elevations in lateral derivations. Emergency coronary angiography revealed normal coronary vessels. He was eventually diagnosed with an anaphylactic reaction. After successful treatment of anaphylaxis, ST-segment elevations resolved. Clinicians should be aware of this syndrome for promt recognition and proper treatment. Keywords: Kounis syndrome; Anaphylaxis; Diclofenac potassium