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Current Drug Safety

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ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

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Case Report

Isolated Tongue Angioedema after Alteplase Infusion in Acute Ischemic Stroke

Author(s): Ermanno Pisani, Carmen Gaudiano, Alfredo Petrone, Furio Stancati and Antonio Siniscalchi*

Volume 17, Issue 1, 2022

Published on: 28 July, 2021

Page: [75 - 77] Pages: 3

DOI: 10.2174/1574886316666210728104331

Price: $65

Abstract

Background: Angioedema, like anaphylaxis, has been reported as a rare adverse event of alteplase infusion in acute ischemic stroke.

Objective: We report the case of a patient with acute ischemic stroke who, after treatment of alteplase, developed angioedema.

Methods: We report the case of an 81-year-old woman who presented to our observation with acute ischemic stroke. The patient was on therapy with 100 mg acetylsalicylic acid and a triple combination antihypertensive drug (perindopril 10 mg + 2.5 mg indapamide + 5 mg amlodipine). The patient was treated with alteplase infusion.

Results: Five minutes after the end of the alteplase infusion (0.9 mg/kg for 1 hour), the patient developed isolated angioedema of the lips and tongue.

Conclusion: Although the incidence of alteplase-induced angioedema in these patients is rare, this case report suggests the need for a routine inspection of the tongue in an acute ischemic patient in treatment with alteplase infusion, especially in female patients in treatment with ACE inhibitors.

Keywords: ACE inhibitor, acute ischemic stroke, angioedema, alteplase, woman, alteplase infusion.

« Previous Next »
[1]
Siniscalchi A, De Sarro G, Pacifici R, Pisani E, Sanguigni S, Gallelli L. Thrombolytic therapy in cocaine users with ischemic stroke: A review of current practice. Psychopharmacol Bull 2019; 49(1): 70-9.
[PMID: 30858640]
[2]
Anticoli S, Bravi MC, Perillo G, et al. Effect of cardioembolic etiology on intravenous thrombolysis efficacy for acute ischemic stroke. Curr Neurovasc Res 2016; 13(3): 193-8.
[http://dx.doi.org/10.2174/1567202613666160506125426] [PMID: 27149937]
[3]
Alakbarzade V, O’Kane D, Pereira AC. Hypersensitivity reactions to recombinant tissue plasminogen activator. Pract Neurol 2020; 20(1): 75-9.
[PMID: 31273082]
[4]
Hill MD, Barber PA, Takahashi J, Demchuk AM, Feasby TE, Buchan AM. Anaphylactoid reactions and angioedema during alteplase treatment of acute ischemic stroke. CMAJ 2000; 162(9): 1281-4.
[PMID: 10813008]
[5]
Cheng JN, Lee A, Jannes J, Heddle RJ, Koblar SA. A patient with anaphylaxis after alteplase infusion. J Clin Neurosci 2012; 19(2): 314-5.
[http://dx.doi.org/10.1016/j.jocn.2011.07.018] [PMID: 22099072]
[6]
Brown SGA. The pathophysiology of shock in anaphylaxis. Immunol Allergy Clin North Am 2007; 27(2): 165-175, v.
[http://dx.doi.org/10.1016/j.iac.2007.03.003] [PMID: 17493496]
[7]
Molinaro G, Gervais N, Adam A. Biochemical basis of angioedema associated with recombinant tissue plasminogen activator treatment: an in vitro experimental approach. Stroke 2002; 33(6): 1712-6.
[http://dx.doi.org/10.1161/01.STR.0000017284.77838.87] [PMID: 12053016]
[8]
Gameiro C, Romao F. Changes in the immune system during menopause and aging. Front Biosci (Elite Ed) 2010; 2: 1299-303.
[http://dx.doi.org/10.2741/e190] [PMID: 20515802]
[9]
Bennett WR, Yawn DH, Migliore PJ, et al. Activation of the complement system by recombinant tissue plasminogen activator. J Am Coll Cardiol 1987; 10(3): 627-32.
[http://dx.doi.org/10.1016/S0735-1097(87)80206-1] [PMID: 3114350]
[10]
Siniscalchi A, Gallelli L, Malferrari G, et al. Cerebral stroke injury: the role of cytokines and brain inflammation. J Basic Clin Physiol Pharmacol 2014; 25(2): 131-7.
[http://dx.doi.org/10.1515/jbcpp-2013-0121] [PMID: 24515999]
[11]
Siniscalchi A, Iannacchero R, Anticoli S, Pezzella FR, De Sarro G, Gallelli L. Anti-inflammatory strategies in stroke: A potential therapeutic target. Curr Vasc Pharmacol 2016; 14(1): 98-105.
[http://dx.doi.org/10.2174/1570161113666150923111329] [PMID: 26411421]
[12]
Austinat M, Braeuninger S, Pesquero JB, et al. Blockade of bradykinin receptor B1 but not bradykinin receptor B2 provides protection from cerebral infarction and brain edema. Stroke 2009; 40(1): 285-93.
[http://dx.doi.org/10.1161/STROKEAHA.108.526673] [PMID: 18988906]

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