Tolu-Akinnawo Oluwaremilekun, Ogwu Oghanim I, Nnamani Ikenna, Talabi Taiwo
Internal Medicine, Meharry Medical College, Nashville, USA.
Cureus. 2023 May 8;15(5):e38714. doi: 10.7759/cureus.38714. eCollection 2023 May.
Intravenous tissue plasminogen activator (tPA) remains the standard of treatment for patients presenting with acute ischemic stroke within the treatment window. In most patients, this often leads to an effective and life-prolonging intervention in the acute setting. This is, however, not without complications, which sometimes could be potentially fatal. Hemorrhagic complications, such as hemorrhagic conversion and bleeding, are the most discussed; however, facial angioedema has also been reported. We present a case of a 72-year-old African American male who developed right-sided ipsilateral orolingual angioedema 20 minutes after starting a tPA infusion. He was subsequently managed with antihistamine medications and steroids with interval resolution of symptoms. This case highlights the need for close monitoring while on tPA infusion, early detection, and management of potential facial angioedema complications. It also serves as a template for further studies focusing on preventative strategies for tPA-induced angioedema.
静脉注射组织型纤溶酶原激活剂（tPA）仍然是在治疗窗内出现急性缺血性卒中患者的治疗标准。在大多数患者中，这通常会在急性期带来有效的、延长生命的干预措施。然而，这并非没有并发症，有时这些并发症可能是致命的。出血性并发症，如出血性转化和出血，是讨论最多的；然而，面部血管性水肿也有报道。我们报告一例72岁非裔美国男性患者，在开始tPA输注20分钟后出现右侧同侧口腔舌部血管性水肿。随后他接受了抗组胺药物和类固醇治疗，症状逐渐缓解。该病例强调了在tPA输注期间进行密切监测、早期发现和处理潜在面部血管性水肿并发症的必要性。它还为进一步研究tPA诱导的血管性水肿的预防策略提供了一个模板。
