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Hypersensitivity reactions to recombinant tissue plasminogen activator.

Alakbarzade, V; O'Kane, D; Pereira, AC (2020) Hypersensitivity reactions to recombinant tissue plasminogen activator. Pract Neurol, 20 (1). pp. 75-79. ISSN 1474-7766 https://doi.org/10.1136/practneurol-2018-002189
SGUL Authors: Pereira, Anthony Chrysoligo

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Abstract

Recombinant tissue plasminogen activator (rtPA) is currently the only approved thrombolytic agent for treating acute ischaemic stroke that is widely used in clinical practice. However, it may cause haemorrhage and hypersensitivity reactions. Orolingual angioedema is an infrequent, usually mild but potentially life threatening, hypersensitivity reaction to rtPA. Our understanding of the basic biology of angioedema has increased in recent years. There is growing evidence that rtPA-induced orolingual angioedema is driven mainly by bradykinin generation rather than it being an anaphylactic response. Monitoring is important because orolingual angioedema may evolve and compromise airways and a small number do have angioedema as part of systemic anaphylaxis. There are no published guidelines for treating rtPA-induced orolingual angioedema, although some evidence suggests that those refractory to standard antianaphylactic agents may resolve with bradykinin B2 receptor antagonists. It is important that responses to orolingual angioedema are proportionate and that patients are closely monitored.

Item Type: Article
Additional Information: This article has been accepted for publication in Practical Neurology, 2019 following peer review, and the Version of Record can be accessed online at https://doi.org/10.1136/practneurol-2018-002189 © Author(s) (or their employer(s)) 2020.
Keywords: acute ischemic stroke, b2-receptor antagonists, bradykinin, hypersensitivity reactions, orolingual angioedema, recombinant tissue plasminogen activator, acute ischemic stroke, b2-receptor antagonists, bradykinin, hypersensitivity reactions, orolingual angioedema, recombinant tissue plasminogen activator, Neurology & Neurosurgery
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Pract Neurol
ISSN: 1474-7766
Language: eng
Dates:
DateEvent
14 January 2020Published
4 July 2019Published Online
21 May 2019Accepted
Publisher License: Publisher's own licence
PubMed ID: 31273082
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/111096
Publisher's version: https://doi.org/10.1136/practneurol-2018-002189

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