Kounis syndrome in a patient with secondary mast cell activation syndrome after a bee sting

Abstract

A 64-year-old male patient was admitted to our clinic with complaints of hot flashes all over the body, fainting and loss of consciousness after a bee sting. The patient who had no history of coronary artery disease was fitted with a stent in the LADcoronary artery with a percutaneous coronary angioplasty by complaints of chest pain and shortness of breath after the bee sting. I3 Vespula spp (yellow jacket) in serum was positive at 0.39 kUA / L-class 1. Tryptase levels were elevated at 19.5/g/L during the asymptomatic period. After the tryptase levels remained elevated at 49.2/g/L during the asymptomatic period after 4 weeks. Thebone marrow biopsy revealed a mast cell ratio of 2%. Based on the patient’s history, physical examination and laboratory findings, the patient was considered to have Kounis syndrome, mast cell activation syndrome and a venom allergy.