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The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France

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Alteplase (rTPA)

2

VIII.a Angioedema (may cause UAO, asphyxia and death)

1
Last update : 10/07/2012
 
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Diagnosing DIRD
1
Drug and radiation history
2
Drug singularity - Correct identification of the drug
3
Consistent timing of exposure v. onset of symptoms
4
Clinical, imaging, BAL, pathological pattern consistent with the specific drug
5
Careful exlusion of another cause
6
Remission of symptoms with removal of drug
7
Recurrence with rechallenge (rarely advisable)
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Causality assessment
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See also under
Angiotensin converting enzyme inhibitors (ACEI)
5
Tissue plasminogen activator (r-)
1

Publications

Angioedema After Use of Recombinant Tissue-Type Plasminogen Activators in Stroke.
Stroke 2024 Aug;55;2193-2197 2024 Aug
Angioedema after rt-PA infusion led to airway emergency: a case report of rescue treatment with fresh frozen plasma.
Brazilian journal of anesthesiology (Elsevier) 2023;73;223-226 2023
Angioedema Secondary to tPA Use in Acute Ischemic Stroke Patient with Hypertension: A Case Report.
Clinical practice and cases in emergency medicine 2021 May;5;159-162 2021 May
Hemilingual Angioedema after Thrombolysis in a Patient on an Angiotensin II Receptor Blocker.
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association 2019 May;28;e44-e45 2019 May
Angioedema after thrombolysis with tissue plasminogen activator: an airway emergency.
Oxford medical case reports 2019 Jan;2019;omy112 2019 Jan
Institutional Incidence of Severe tPA-Induced Angioedema in Ischemic Cerebral Vascular Accidents.
Critical care research and practice 2018;2018;9360918 2018
A Novel Approach to the Treatment of Orolingual Angioedema After Tissue Plasminogen Activator Administration.
Annals of emergency medicine 2016 Sep;68;345-8 2016 Sep
Orolingual angiodema associated with alteplase treatment of acute stroke: a reappraisal.
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association 2015 Jan;24;31-40 2015 Jan
Angioedema from recombinant TPA administration: case report and pathophysiology review.
American journal of therapeutics 2013;20;691-3 2013
Angioedema after tPA: what neurointensivists should know.
Neurocritical care 2012 Jun;16;440-3 2012 Jun
Lingual angioedema with macroglossia during the treatment of acute ischemic stroke with alteplase.
International journal of general medicine 2012;5;183-6 2012
[Orolingual angioedema under systemic thrombolysis with rt-PA: an underestimated side effect].
Der Nervenarzt 2009 Apr;80;459-63 2009 Apr
[Orolingual angioedema secondary to alteplase treatment in cases of stroke].
Revista de neurologia 2008 Mar 16-31;46;382 2008 Mar 16-31
[Angioneurotic orolingual edema associated with the use of rt-PA following a stroke].
Der Anaesthesist 2007 Oct;56;1024-7 2007 Oct
Biochemical basis of angioedema associated with recombinant tissue plasminogen activator treatment: an in vitro experimental approach.
Stroke 2002 Jun;33;1712-6 2002 Jun
Anaphylactoid reactions and angioedema during alteplase treatment of acute ischemic stroke.
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne 2000 May 02;162;1281-4 2000 May 02

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