Department of Pharmacy, Methodist University Hospital, 1265 Union Avenue, Memphis, TN 38104, United States of America; Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Sciences College of Pharmacy, 881 Madison Avenue, Memphis, TN 38163, United States of America.
Department of Pharmacy, Methodist University Hospital, 1265 Union Avenue, Memphis, TN 38104, United States of America.
Am J Emerg Med. 2023 May;67:196.e1-196.e2. doi: 10.1016/j.ajem.2023.03.016. Epub 2023 Mar 12.
Tissue plasminogen activator (tPA) is a cornerstone treatment for acute ischemic stroke (AIS). Administration of tPA is not without risk, and can provoke life threatening adverse reactions. Retropharyngeal hematoma (RPH) following tPA administration has only been reported after tenecteplase (TNK) administration for ST elevation myocardial infarction (STEMI). A 78 year old patient received tPA for AIS. Following administration of tPA, this patient developed acute signs and symptoms of what appeared to be a more well-known adverse reaction of tPA administration - angioedema. After CT and laboratory findings, our patient received cryoprecipitate for tPA reversal. Our case highlights a unique case of RPH mimicking angioedema following tPA administration.
组织型纤溶酶原激活剂（tPA）是急性缺血性脑卒中（AIS）的基石治疗方法。tPA 的使用并非没有风险，它可能引发危及生命的不良反应。tPA 给药后发生的咽后血肿（RPH）仅在替奈普酶（TNK）用于治疗 ST 段抬高型心肌梗死（STEMI）后有报道。一名 78 岁的患者因 AIS 接受 tPA 治疗。tPA 给药后，该患者出现急性症状和体征，这些症状和体征似乎是 tPA 给药更常见的不良反应——血管性水肿。在 CT 和实验室检查结果后，我们的患者接受了冷沉淀以逆转 tPA。我们的病例突出了一个独特的 RPH 病例，该病例在 tPA 给药后模仿血管性水肿。
