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A 60-year-old man experienced anaphylaxis and Kounis syndrome, leading to cardiac arrest and refractory shock, while being treated with amiodarone for atrial fibrillation. He also showed lack of efficacy when treated with other medications for refractory shock. The man had a history of atrial fibrillation and was treated with amiodarone and apixaban. After receiving amiodarone, he developed a skin rash, followed by cardiac arrest and refractory shock. He was treated with various interventions, including mechanical circulatory support, and eventually recovered. At a one-year follow-up, he remained asymptomatic with controlled heart rate and continued treatment. [Extracted from the article]

A 41-year-old man developed Kounis syndrome while being treated with vancomycin for suspected cellulitis. The man had psoriasis and hidradenitis suppurativa following surgical procedures. He was admitted to the hospital with a rash, headache, fever, malaise, and chills. After receiving three doses of vancomycin, he experienced chest discomfort, nausea, and headache. Vancomycin was discontinued and he was switched to cefazolin. He did not experience chest pain recurrence after discontinuing vancomycin. [Extracted from the article]

A 41-year-old man developed Kounis syndrome while being treated with vancomycin for suspected cellulitis. The man had previously undergone surgical procedures for psoriasis and hidradenitis suppurativa. He was admitted to the hospital with a rash, fever, headache, and other symptoms. After receiving several doses of vancomycin, he experienced chest discomfort, but it resolved after treatment with aspirin and heparin. Vancomycin was discontinued and replaced with cefazolin. [Extracted from the article]

A 40-year-old woman experienced Kounis syndrome, a condition characterized by anaphylactic shock, as a result of taking ibuprofen for chronic pain. The woman had pre-existing conditions including hypertension, Hashimoto's disease, asthma, and autoimmune hepatitis. She developed chest pain, lip/facial swelling, and difficulty breathing shortly after taking a new medication and waking up. Laboratory tests revealed elevated troponin levels and CRP, leading to a diagnosis of Kounis syndrome secondary to anaphylactic shock caused by ibuprofen. The woman was treated with epinephrine and underwent a coronary artery bypass graft before being discharged. [Extracted from the article]

A 24-year-old man experienced Kounis syndrome, a drug allergy, while being treated with aspirin and ibuprofen. He had previously received corticosteroid treatment for nasal polyps and presented with epigastric pain after meals. Coronary angiography revealed a stenosis in the left anterior descending artery, and he was discharged with aspirin and a statin. However, he developed chest pain and was admitted to the ICU. After receiving ibuprofen, he experienced tongue swelling and recurrent chest pain. Coronary angiography showed vasospasm, which improved with nitrate treatment. He was diagnosed with Kounis syndrome based on elevated eosinophils and IgE levels. The man received various medications for treatment, but the outcome is not stated. [Extracted from the article]

A 64-year-old man experienced Kounis syndrome type II and pruritus after receiving regadenoson for stress myocardial perfusion imaging and aspirin for coronary artery stenosis. The man initially presented with chest pain and ST segment elevation after regadenoson administration, which was resolved with nitroglycerin. Further investigation revealed calcified stenosis of the coronary artery and systemic mastocytosis. The man was diagnosed with Kounis syndrome type II caused by regadenoson and aspirin was discontinued, with the patient remaining on ticagrelor monotherapy. [Extracted from the article]

A 77-year-old man experienced coronary steal syndrome while being treated with adenosine for coronary artery disease. The man had a history of coronary artery disease and had previously undergone bypass surgery. After receiving adenosine, he developed ventricular fibrillation and became unresponsive. Return of spontaneous circulation was achieved after defibrillation and compressions. Further examination revealed chronic occlusions caused by prior bypass grafts, leading to the development of coronary steal syndrome. The man's left ventricular ejection fraction was also found to be decreased. He postponed the use of a LifeVest or defibrillator until further discussion with his outpatient cardiologist. [Extracted from the article]

A man in his 40s with Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL) experienced lack of efficacy with dasatinib treatment. He then received brexucabtagene-autoleucel and developed cytokine release syndrome and immune effector cell associated neurotoxicity syndrome, which resolved. The patient later showed improvement in ALL and underwent a second allogeneic hematopoietic stem-cell transplantation. [Extracted from the article]

In a cohort study of 603 patients with relapsed/refractory multiple myeloma (RRMM), two patients experienced serious adverse events while receiving treatment with idecabtagene-vicleucel. One patient developed cytokine release syndrome (CRS) and the other experienced tumor lysis. Unfortunately, both patients died as a result of these complications. The specific details of the patients' ages, sexes, dosages, and routes of administration were not provided in the article. [Extracted from the article]

In a study of 23 patients with relapsed/refractory mantle cell lymphoma (R/R MCL), two patients developed cytokine release syndrome and multiple organ dysfunction syndrome after receiving treatment with brexucabtagene-autoleucel. The patients had previously received unspecified treatments and leukapheresis. One patient experienced Grade ≥3 cytokine release syndrome, while the other developed grade 5 multiple organ dysfunction syndrome on day 20 after the infusion. The specific details of the treatment, dosages, and outcomes were not provided in the article. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventA 46-year-old woman developed bilateral acute iris transillumination (BAIT) syndrome following treatment with moxifloxacin/dexamethasone for bilateral bacterial conjunctivitis, and exhibited a lack of efficacy following treatment with atropine, prednisolone-acetate and an unspecified beta-adrenergic-receptor-antagonists, carbonic-anhydrase-inhibitors and steroids for ocular hypertension [not all routes stated]. [Extracted from the article]

A 60-year-old woman experienced type I Kounis syndrome while being treated with flurbiprofen for upper abdominal pain. She had a history of hypertension and asthma, as well as a previous allergic reaction to omeprazole and rabeprazole. After receiving the first dose of flurbiprofen, she developed symptoms such as cold sweats, shortness of breath, chest tightness, fatigue, rashes, itching, and prolonged chest pain. She was immediately admitted to the resuscitation room and received various treatments, including methylprednisolone, dexamethasone, epinephrine, and metaraminol. Emergency coronary angiography showed no significant issues, and her condition improved with treatment. She was discharged after seven days and had no recurrence of symptoms at the two-month follow-up. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventA 63-year-old man exhibited lack of efficacy during treatment with epinephrine, methylprednisolone, diphenhydramine and famotidine for type 2 Kounis syndrome (KS). [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventA 59-year-old woman developed anaphylaxis and Kounis syndrome (KS) type 1 during treatment with oxaliplatin for rectal carcinoma [dosage, time to reaction onset, route and outcomes for ADRs not stated]. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventA male patient [Name: Devagiri; age not stated] developed Kounis syndrome type I during treatment with capecitabine [indication, route and dosage not stated]. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventA man in his late 40s [exact age not stated] developed Kounis syndrome during treatment with omeprazole for dyspepsia [dosage, route and duration of treatment to reaction onset not stated]. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventA female child [exact age at the event onset not stated] developed nephrotoxicity during treatent with ciclosporin for nephrotic syndrome. Additionally, she developed resistance during treatment with prednisone for nephrotic syndrome [route, time to reaction onset and outcomes not stated]. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventA 56‑year‑old man developed type·2 Kounis syndrome during antibiotic prophylaxis with cefuroxime. In addition, he developed ventricular fibrillation during treatment with epinephrine for type·2 Kounis syndrome [dosages not stated]. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventA 51-year-old man developed Kounis syndrome duirng treatment with sulfur-hexafluoride as contrast agent. [Extracted from the article]

It was considered that the IRIS-like reconstitution syndrome was attributed to the discontinuation of cyclophosphamide, methotrexate, dexamethasone, vincristine, and prednisone. Corticosteroids/gammaglobulin/immunosuppressants: Cryptococcal meningitis caused by Cryptococcus neoformans, immune reconstitution inflammatory syndrome-like reconstitution syndrome following drug withdrawal, and no effect: case report She developed Cryptococcal meningitis (CM) caused by I Cryptococcus neoformans i during immunosuppressive treatment with cyclophosphamide, methotrexate, dexamethasone and vincristine. [Extracted from the article]

Increased expression of human herpes virus 6 receptor CD134/OX40 in skin lesions of patients with drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms. The patients received allopurinol (3 patients), carbamazepine (11 patients), lamotrigine (2 patients), mexiletine (1 patient), phenobarbital (2 patients) and trichloroethylene (1 patient). [Extracted from the article]

Reference 1 Acetaminophen Risk of drug-induced hypersensitivity syndrome WHO Pharmaceuticals Newsletter: No. 2, 2023. The Japanese Ministry of Health, Labour and Welfare (MHLW) and Pharmaceuticals and Medical Devices Agency (PMDA) have announced that product information for paracetamol (acetaminophen) products should be updated to include the risk of drug-induced hypersensitivity syndrome, according to a report in the I WHO Pharmaceuticals Newsletter i . The MHLW and PMDA assessed 45 cases of drug-induced hypersensitivity syndrome involving paracetamol reported in Japan, and considered that a causal relationship was possible in six cases. [Extracted from the article]