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KMID : 1130620080040010029
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Journal of Clinical Neurology
2008 Volume.4 No. 1 p.29 ~ p.32
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Life-Threatening Anaphylactoid Reaction in an Acute Ischemic Stroke Patient With Intravenous rt-PA Thrombolysis, Followed by Successful Intra-Arterial Thrombolysis
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Park In-Seok
Lee Kwang-Soo
Kim Yeong-In
Kim Joong-Seok
Cho A-Hyun
Lee Seung-Jae
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Abstract
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An anaphylactoid reaction to recombinant tissue plasminogen activator (rt-PA) is an uncommon but fatal
complication. A 39-year-old man was admitted within 1 hour of the onset of a right hemispheric stroke. He was
not taking any specific medication, including angiotensin-converting enzyme (ACE) inhibitors. A systemic
anaphylactoid reaction developed immediately after rt-PA infusion. However, the symptoms were improved after
treatment with a steroid and antihistamine. Subsequent intra-arterial thrombolytic therapy resulted in complete
recanalization and clinical improvement. To our knowledge, this is the first report of a life-threatening anaphylactoid
reaction after rt-PA treatment followed by successful intra-arterial thrombolytic therapy in a patient who had not
taken an ACE inhibitor.
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KEYWORD
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Recombinant tissue plasminogen activator, Acute ischemic stroke, Anaphylactoid reaction
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