Anaphylactoid reactions and angioedema during alteplase treatment of acute ischemic stroke.
Hill MD., Barber PA., Takahashi J., Demchuk AM., Feasby TE., Buchan AM.
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.