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Life-Threatening tPA-Associated Angioedema: A Rare Case Report and Critical Review.
El Labban, Mohamad; El Zibaoui, Roba; Amadi, Alpha C; Zareen, Tashfia; Khan, Syed Anjum.
Afiliación
  • El Labban M; Department of Internal Medicine, Mayo Clinic Health System, Mankato, MN, USA.
  • El Zibaoui R; School of Medicine, American University of Beirut, Beirut, Lebanon.
  • Amadi AC; Department of Nursing, Mayo Clinic, Rochester, MN, USA.
  • Zareen T; School of Medicine, St. George's University, Grenada, Grenada.
  • Khan SA; Department of Critical Care Medicine, Mayo Clinic Health System, Mankato, MN, USA.
Am J Case Rep ; 25: e944221, 2024 Sep 14.
Article en En | MEDLINE | ID: mdl-39275799
ABSTRACT
BACKGROUND Angioedema is characterized by localized self-limiting edema of the deep dermis, subcutaneous, and submucosal tissues. Acute episodes often involve the skin of the face, lips, tongue, limbs, and genitals, as well as internal areas of the body and respiratory and gastrointestinal mucosa, which could be life-threatening. Histamine and bradykinin are the most recognized vasoactive mediators in the pathophysiology of angioedema. Tissue plasminogen activator (tPA) is a fibrinolytic that is commonly used for the treatment of cerebrovascular accidents. Angioedema is a rare adverse effect of tPA, with an estimated incidence of 0.02% in patients with myocardial infarction or pulmonary embolism and 0.2% to 5.1% in patients with stroke. We report a unique case of tPA-associated angioedema with 24-h management. CASE REPORT A 79-year-old male patient presented to the Emergency Department with acute onset right-sided weakness, right-sided facial droop, and speech difficulties. Following the initial evaluation, it was determined that he was a candidate for receiving tPA therapy. On arrival at the Intensive Care Unit, he was noted to have right upper and then lower lip swelling. The patient was asymptomatic and did not show any signs concerning airway compromise. Treatment included systemic corticosteroids and antihistamines. The progression of the angioedema was further described with sequential images. The angioedema was completely resolved with treatment. CONCLUSIONS Angioedema is a rare but potentially life-threatening adverse effect of tPA. Although it generally has a mild self-limiting course, it can cause life-threatening airway compromise.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Activador de Tejido Plasminógeno / Fibrinolíticos / Angioedema Límite: Aged / Humans / Male Idioma: En Revista: Am J Case Rep Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Activador de Tejido Plasminógeno / Fibrinolíticos / Angioedema Límite: Aged / Humans / Male Idioma: En Revista: Am J Case Rep Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos