Drug-Eluting Coronary Stents: Hypersensitivity Reactions to Paclitaxel and the Risk of Kounis Syndrome

The authors of this report anticipated that the allergic symptoms of urticaria, asthma and arthralgia as well as the late skin prick reaction to paclitaxel may indicate type III serum sickness disease. These symptoms have appeared 2 weeks after stent implantation, and this time lag may also indicate immunological sensitization. It is known that paclitaxel is eluted completely within 4–6 weeks after stent implantation. Since paclitaxel-specific IgE binding was not detected, the authors thought that these reactions may be related to toxic or pseudoallergic effects of paclitaxel. However, this patient with paclitaxel-eluting stent implantation was under the influence not only of a sole antigen, but he had received 5 different substances which could have acted as potential antigens. Furthermore, this patient could easily have been exposed, thereafter, to more antigenic agents during his everyday