Relapsing allergic bronchopulmonary aspergillosis as a trigger for Kounis syndrome: a case report
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By
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Haolei Wei
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Liyan Wu
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Bin Ni
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Jingyu Zhang
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Mengxia Xu
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Liang Guo
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Yanping Mao
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June 9, 2026
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Clinical Scorecard: Kounis Syndrome Induced by Relapsing Allergic Bronchopulmonary Aspergillosis: A Case Study
At a Glance
| Category | Detail |
|---|
| Condition | |
| Key Mechanisms | Allergic acute coronary syndrome triggered by hypersensitivity reactions. |
| Target Population | |
| Care Setting | |
Key Highlights
- Kounis syndrome can be triggered by allergic bronchopulmonary aspergillosis (ABPA).
- The patient presented with acute chest tightness and dyspnea during an ABPA relapse.
- Laboratory tests showed eosinophilia, elevated total IgE, and myocardial injury.
- Coronary angiography revealed nonobstructive coronary arteries.
- Management included antifungal therapy, corticosteroids, and coronary vasodilators.
Guideline-Based Recommendations
Diagnosis
- Consider Kounis syndrome in patients with unexplained cardiopulmonary symptoms during ABPA exacerbations.
Management
- Utilize antifungal therapy, systemic corticosteroids, and supportive care for Kounis syndrome.
Monitoring & Follow-up
- Monitor cardiac biomarkers such as cardiac troponin I and B-type natriuretic peptide.
Risks
- Patients with severe allergic airway disease may experience cardiovascular complications.
Patient & Prescribing Data
Treatment included itraconazole, piperacillin-tazobactam, and coronary vasodilators.
Clinical Best Practices
- Maintain cardiovascular vigilance in patients with severe allergic airway disease.
- Recognize the potential for Kounis syndrome in patients with ABPA.
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