title: Anaphylactoid reactions and angioedema during alteplase treatment of acute ischemic stroke.
abstract: 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.
authors.affiliation: Department of Clinical Neurosciences, University of Calgary, Alta. michael.hill@crha-health.ab.ca
authors.forename: M D
authors.initials: MD
authors.lastname: Hill
authors.forename: P A
authors.initials: PA
authors.lastname: Barber
authors.forename: J
authors.initials: J
authors.lastname: Takahashi
authors.forename: A M
authors.initials: AM
authors.lastname: Demchuk
authors.forename: T E
authors.initials: TE
authors.lastname: Feasby
authors.forename: A M
authors.initials: AM
authors.lastname: Buchan
mesh_terms: 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*
chemical_list: D010959:Tissue Plasminogen Activator