Lingual angioedema after alteplase treatment in a patient with acute ischemic stroke

• Published in: World journal of emergency medicine Vol. 6; no. 1; pp. 74 - 76
• Main Authors: Bozkurt, Seyran, Arslan, Engin Deniz, Köse, Ataman, Ayrık, Cüneyt, Yılmaz, Arda, Dündar, Güllü Akbaydoğan
• Format: Report
• Language: English
• Published: 01.01.2015
• ISSN: 1920-8642
• DOI: 10.5847/wjem.j.1920-8642.2015.01.013

BACKGROUNDIn recent years, thrombolytic therapy has become the main treatment of ischemic stroke. But the increasing use of alteplase in ischemic stroke has made some complications more evident. Angioedema is a rare but potentially life-threatening complication of alteplase treatment. Only a few studies have examined the incidence of angioedema after treatment with alteplase for stroke. METHODSA 75-year-old man complaining of right hemiparesis was admitted to our emergency department. He was diagnosed as having acute ischemic stroke, and alteplase infusion was given two hours after the onset of stroke symptoms. Immediately after the completion of infusion he was noted to have a large swollen tongue. RESULTSHis neurological symptoms resolved gradually within 4 hours, whereas his upper extremity strength improved to 4/5 and lower extremity 5/5. Lingual edema resolved within 16 hours without any complication. He died from presumed nosocomial infection 5 days later. CONCLUSIONSLingual angioedema may appear as a possible complication in patients who were treated with alteplase. The management of these patients should be very careful.