Kounis syndrome: a pediatric perspective

Kounis syndrome is defined as a hypersensitivity coronary disorder constituted by the association of an acute coronary syndrome with a hypersensitivity, allergic, anaphylactic or anaphylactoid reaction, in a pathophysiologic context involving mast-cells, platelets, eosinophils and various interacting inflammatory cells. Currently, Kounis syndrome is established in the literature, as accompanied by a plethora of clinical case reports that further elucidating its aspects. To the best of our knowledge, a specific analysis regarding the pediatric data of Kounis syndrome has never been performed. The aim of this review is to reveal all the pediatric Kounis syndrome cases in the literature, in an attempt to define its clinical implications in children. Moreover, based on the data of this analysis, a new classification for Kounis syndrome is proposed, focusing mainly in the presence or the absence of allergic myocardial infarction, as the central clinical feature for the stratification of the patients' clinical manifestations.