Purpose: A case of alteplase administration to a patient with vasculitis and acute ischemic stroke (AIS) is reported.
Summary: A 38-year-old woman with a recent diagnosis of granulomatosis with polyangiitis (GPA) received alteplase for AIS and developed symptomatic hemorrhagic conversion. Published reports regarding the safety of thrombolytic therapy in patients with a high inflammatory burden are inconsistent. The current case adds to the literature on the topic.
Conclusion: More data regarding alteplase treatment in patients with GPA are needed to further establish the safety of this therapy.