Anaphylactoid reactions and angioedema during alteplase treatment of acute ischemic stroke.
Among 105 patients given recombinant tissue plasminogen activator (rt-PA, alteplase) intravenously for acute stroke, 2 (1.9%) had lingual angioedema, which progressed to a fatal anaphylactoid reaction in 1. The authors review the 2 cases and possible mechanisms responsible. They warn that patients who are taking an angiotensin-converting-enzyme inhibitor may be at increased risk for angioedema with concomitant alteplase therapy.
Hill
M D
MD
Department of Clinical Neurosciences, University of Calgary, Alta. michael.hill@crha-health.ab.ca
Barber
P A
PA
Takahashi
J
J
Demchuk
A M
AM
Feasby
T E
TE
Buchan
A M
AM
D000368:Aged; D000707:Anaphylaxis / Q000139:chemically induced* / Q000175:diagnosis; D000799:Angioedema / Q000139:chemically induced* / Q000175:diagnosis; D002544:Cerebral Infarction / Q000188:drug therapy*; D003937:Diagnosis, Differential; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects*
D010959:Tissue Plasminogen Activator