• Chunjiang Wang, Zhenzhen Deng, Liying Song, Wei Sun, Weijin Fang, and Zuojun Li.
• Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China.
• Am J Emerg Med. 2022 Feb 1; 52: 203-207.

BackgroundUnderstanding the relationship between contrast agents and Kounis syndrome (KS) is mainly based on case reports. The purpose of this research is to explore the clinical characteristics of contrast media induced KS.MethodsWe searched for contrast-induced KS case reports through Chinese and English databases from 1991 to October 31, 2021.ResultsA total of 26 patients (19 men and 7 women,) were included, with a median age of 60 years (range 30-83). The contrast agents that cause KS mainly included gadolinium-based contrast agent (7 cases), iodine-containing contrast media (12 cases). KS mainly occurred within 30 min after administration and mainly manifests as chest pain and allergic reactions. Electrocardiogram (ECG) mainly showed ST elevation. Echocardiography mainly revealed normal. Coronary angiography showed normal, coronary vasospasm, stent thrombosis, occlusion and stenosis. After treatment with steroids, antihistamines and anti-ischemic therapy, 24 patients recovered completely and 2 patients died.ConclusionsKS is a rare adverse reaction of contrast media. Radiologists should recognize this rare but serious disease to ensure rapid diagnosis and proper management.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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