Time to reconsidering the potential role of leech salivary proteins in medicine: Type-II Kounis syndrome triggered by leech bite
Case report published in Pakistan Journal of Medical Sciences (2025)
Abstract
Kounis syndrome also known as allergic myocardial infarction, represents the simultaneous occurrence of acute coronary syndromes with allergic or hypersensitivity reactions. We present a case of a 58-years-old male who developed anaphylaxis following a leech bite, leading to myocardial infarction despite the absence of prior allergic history. He was entubated and cardiopulmonary resusciation had been performed for 10 minutes. The patient was successfully resuscitated and Intravenous antihistamine, prednisolone and adrenaline were given. The patient was stabilized and transferred to the intensive care unit and coronary angiography was performed, which revealed a 90% stenosis in the circumflex coronary artery. A stent was successfully implanted in the affected artery. This report emphasizes the complexity of diagnosing and managing Type-II Kounis syndrome and highlights the need for increased clinical awareness.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
58-year-old male developed anaphylaxis with myocardial infarction (Type-II Kounis syndrome) after leech bite, requiring resuscitation and emergency stenting of LCX. Survived after multidisciplinary management.
Why This Matters for Hirudotherapy
This case report describes a 58-year-old male who developed anaphylaxis and myocardial infarction (Type-II Kounis syndrome) following a leech bite, despite having no prior allergic history. The patient required intubation and 10 minutes of cardiopulmonary resuscitation, was treated with intravenous antihistamine, prednisolone, and adrenaline, and underwent coronary angiography revealing 90% stenosis in the circumflex artery, which was stented successfully. This report is relevant to ASH and hirudotherapy safety, documenting a severe cardiovascular complication temporally associated with leech exposure. However, the evidence is limited to a single case report without a control group or systematic assessment of incidence, and the underlying mechanism is not investigated.
Citation
Time to reconsidering the potential role of leech salivary proteins in medicine: Type-II Kounis syndrome triggered by leech bite.
Tas S et al. · Pakistan journal of medical sciences, 2025
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