we read with interest the letter by Mirijello et al. [1] which emphasizes the importance of Kounis syndrome (KS), Takotsubo syndrome and their copresence in ATAK syndrome among cardiovascular manifestations of anaphylaxis. These are peculiar syndromes with yet uncompleted ascertained epidemiology (at least for KS) which may occur during anaphylaxis, complicate its course, and require special monitoring and management (namely exclusive intramuscular administration of adrenaline in a closely supervised setting for KS) [2,3].
