Letters To The Editor
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Dec 14, 2008; 14(46): 7141-7142
Published online Dec 14, 2008. doi: 10.3748/wjg.14.7141
Mesalamine hypersensitivity and Kounis syndrome in a pediatric ulcerative colitis patient
George N Kounis, Sophia A Kouni, George Hahalis, Nicholas G Kounis
George N Kounis, Sophia A Kouni, George Hahalis, Nicholas G Kounis, Department of Medical Sciences, Patras Highest Institute of Education and Technology, 7 Aratou Street, Queel Olgas Square Patras 26221, Greece
Author contributions: All authors contributed equally to this work.
Correspondence to: Nicholas G Kounis, MD, Professor, Department of Medical Sciences, Patras Highest Institute of Education and Technology, 7 Aratou Street, Queel Olgas Square Patras 26221, Greece. ngkounis@otenet.gr
Telephone: +30-26-10279579 Fax: +30-26-10279579
Received: October 2, 2008
Revised: November 1, 2008
Accepted: November 8, 2008
Published online: December 14, 2008
Abstract

5-aminosalicylic acid (mesalamine) rarely induces hypersensitivity reactions. If chest pain associated with atypical electrocardiographic changes are seen during its administration, one should always bear in mind typeIvariant of Kounis syndrome. This variant includes patients, of any age, with normal coronary arteries, without predisposing factors for coronary artery disease, in whom the acute release of inflammatory mediators from mast cells can induce either sudden coronary artery narrowing, without increase of cardiac enzymes and troponins, or coronary artery spasm that progresses to acute myocardial infarction, with elevated cardiac enzymes and troponins.

Keywords: Drug hypersensitivity; Kounis syndrome; Mesalamine; Salicylates