Title:Isolated Tongue Angioedema after Alteplase Infusion in Acute Ischemic
Stroke
Volume: 17
Issue: 1
Author(s): Ermanno Pisani, Carmen Gaudiano, Alfredo Petrone, Furio Stancati and Antonio Siniscalchi*
Affiliation:
- Department of Neurology and Stroke Unit, Annunziata Hospital of Cosenza, Cosenza, Italy
Keywords:
ACE inhibitor, acute ischemic stroke, angioedema, alteplase, woman, alteplase infusion.
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.
