title: Persistent, severe post-thrombolysis angioedema: Simple management of a difficult problem.
abstract: Post-thrombolysis orolingual angioedema in the setting of managing acute stroke is reported in the literature as most often being mild and self-limiting. We present a case of severe angioedema resulting in persistent macroglossia, representing a different end of the spectrum of disease than that referenced in the literature. Despite the severity of the tongue edema in our case, it did resolve with a relatively simple intervention. In addition to highlighting that post-thrombolysis angioedema can be potentially life threatening, this report reviews the pathophysiology of this condition and discusses management options for macroglossia in this setting.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of Toronto, c/o Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada. Electronic address: aforeman@adam.com.au.
authors.forename: Andrew
authors.initials: A
authors.lastname: Foreman
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of Toronto, c/o Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada.
authors.forename: Tara
authors.initials: T
authors.lastname: He
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of Toronto, c/o Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Chan
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of Toronto, c/o Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada.
authors.forename: Ralph
authors.initials: R
authors.lastname: Gilbert
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of Toronto, c/o Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada.
authors.forename: Patrick
authors.initials: P
authors.lastname: Gullane
mesh_terms: D000799:Angioedema / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D000792:Angiography; D019468:Disease Management; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000188:drug therapy*; D008875:Middle Aged; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D014060:Tongue Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy
chemical_list: D005343:Fibrinolytic Agents