ReviewTexas Heart Institute journal2023
Kounis Syndrome Associated With the Use of Diclofenac.
Review in Texas Heart Institute journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Treatment of Acute Psychosis Caused by Isotretinoin: Systematic Review.Psychiatry and clinical psychopharmacology · 2024Pooled it
- Kounis Syndrome Type II after Diclofenac Exposure: Unmasking a Link Between Drug Allergy and Acute Coronary Syndrome.Arquivos brasileiros de cardiologia · 2026Article
- Relapsing allergic bronchopulmonary aspergillosis as a trigger for Kounis syndrome: a case report.Frontiers in cardiovascular medicine · 2026Article
- Article
- Global Burden of Allergies: Mechanisms of Development, Challenges in Diagnosis, and Treatment.Life (Basel, Switzerland) · 2025Review
- Triggers, Types, and Treatments for Kounis Syndrome: A Systematic Review.Clinics and practice · 2025Review
- Cardiac Arrest Due to Kounis Syndrome Following Cephazolin Administration During Surgery Under Local Anesthesia.Cureus · 2023Article
- Case Report: Flurbiprofen-induced Type I Kounis syndrome.Frontiers in cardiovascular medicine · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiclofenac is a widely used analgesic, anti-inflammatory, antipyretic drug. In several case reports, its use was associated with the occurrence of Kounis syndrome. The aim of this review was to investigate and summarize published cases of Kounis syndrome suspected to be associated with the use of diclofenac.
methodsElectronic searches were conducted in PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, and the Serbian Citation Index.
resultsTwenty publications describing the 20 patients who met inclusion criteria were included in the systematic review. Specified patient ages ranged from 34 to 81 years. Eighteen (90.0%) patients were male. Five patients (25.0%) reported a previous reaction to diclofenac. Reported time from the used dose of diclofenac to onset of the first reaction symptoms ranged from immediately to 5 hours. Diclofenac caused both type I and type II Kounis syndrome, with the presence of various cardiovascular, gastrointestinal, dermatologic, and respiratory signs and symptoms. Most patients experienced hypotension (n = 15 [75.0%]) and chest pain (n = 12 [60.0%]). The most frequently reported finding on electrocardiogram was ST-segment elevations (n = 17 [85.0%]). Coronary angiogram showed normal coronary vessels in 9 patients (45.0%), with some pathologic findings in 8 patients (40.0%).
conclusionClinicians should be aware that Kounis syndrome may be an adverse effect of diclofenac. Prompt recognition and withdrawal of the drug, with treatment of both allergic and cardiac symptoms simultaneously, is important.
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