Isolated Tongue Angioedema after Alteplase Infusion in Acute Ischemic Stroke

Curr Drug Saf. 2022;17(1):75-77. doi: 10.2174/1574886316666210728104331.

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; alteplase; alteplase infusion; angioedema; woman.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Angioedema* / chemically induced
  • Angioedema* / drug therapy
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects
  • Female
  • Fibrinolytic Agents / adverse effects
  • Humans
  • Ischemic Stroke*
  • Stroke* / chemically induced
  • Stroke* / complications
  • Stroke* / drug therapy
  • Tissue Plasminogen Activator / adverse effects
  • Tongue

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Fibrinolytic Agents
  • Tissue Plasminogen Activator