Hemilingual Angioedema after Thrombolysis in a Patient on an Angiotensin II Receptor Blocker

Orolingual angioedema (OLAE) is a rare adverse effect of alteplase. Previous studies have associated the occurrence of OLAE with thrombolysed patients maintained on angiotensin converting enzyme inhibitors. We report a case of a 60-year-old male presenting with hyperacute ischemic stroke developing...

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Bibliographic Details
Published in:	Journal of stroke and cerebrovascular diseases Vol. 28; no. 5; pp. e44 - e45
Main Authors:	Diestro, Jose Danilo Bengzon, Sedano, Lady Scarlette Pacsi, Reyes, Nikolai Gil Diwa, San Jose, Maria Cristina Zarsadias
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-05-2019
Subjects:	acute stroke Alteplase orolingual angioedema thrombolysis tongue swelling thrombolysis tongue swelling orolingual angioedema Alteplase acute stroke
Online Access:	Get full text
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Summary:	Orolingual angioedema (OLAE) is a rare adverse effect of alteplase. Previous studies have associated the occurrence of OLAE with thrombolysed patients maintained on angiotensin converting enzyme inhibitors. We report a case of a 60-year-old male presenting with hyperacute ischemic stroke developing hemilingual edema after thrombolysis. He was previously maintained on an angiotensin II receptor blocker (ARB), losartan. The swelling resolved over 2 days with immediate administration of intravenous steroids and antihistamine drugs. Our case is the third documented case of OLAE occurring in a thrombolysed patient concurrently taking an ARB. The presence of hemilingual edema in a post-thrombolysis patient maintained on losartan suggests a possible association between OLAE and ARBs.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1052-3057 1532-8511
DOI:	10.1016/j.jstrokecerebrovasdis.2019.01.030