[Transmural myocardial infarction and Prinzmetal's syndrome in an allergic reaction to glafenine. Physiopathological discussion. Apropos of a case].

Abstract

The authors report the case of a 38 year old man who experienced at two month' interval, hypersensitivity reactions to the ingestion of 200 mg tablets of glafenine, complicated on the first occasion by a transmural anterior wall myocardial infarction as the first manifestation of coronary artery disease and on the second occasion by Prinzmetal angina due to posterior wall ischaemia. Coronary angiography was more or less normal. The timing of the symptoms in the context of an anaphylactic reaction and their repetition when the same molecule was reintroduced are strong arguments in favour of the pathogenic role of glafenine, even in the absence of biological criteria which are always variable. The mechanism of the coronary problems is discussed with reference to mediators released during the anaphylactic reaction: coronary vasoconstriction due to histamine and leukotriene release; inhibition of prostaglandin synthesis causing potentiation of the effects of histamine; lowering of the vasodilatory and antiaggregant prostacyclin enhancing the vasoconstrictor and platelet aggregant action of thromboxane A2. All the conditions favouring the initiation of coronary spasm with eventual coronary thrombosis, the one aggravating the other, are therefore present.

• Authors: R Lainée, M M Desaint, S Godard, G Le Tessier, M Ertel, H Hooreman, P Sablon, M Bellorini, M Lévy, F Besse
• Journal: Archives des maladies du coeur et des vaisseaux (Arch Mal Coeur Vaiss) Vol. 78 Issue 6 Pg. 955-9 (Jun 1985) ISSN: 0003-9683 [Print] France
• Vernacular Title: Infarctus myocardique transmural et syndrome de Prinzmetal au cours d'une réaction allergique à la glafénine. Discussion physiopathologique. A propos d'un cas.
• PMID: 2864026 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• ortho-Aminobenzoates
• Glafenine

Topics

• Adult
• Angina Pectoris, Variant (chemically induced, physiopathology)
• Drug Hypersensitivity (complications, physiopathology)
• Glafenine (adverse effects)
• Humans
• Male
• Myocardial Infarction (chemically induced, physiopathology)
• ortho-Aminobenzoates (adverse effects)