Orolingual bradykinin angioedema after tissue plasminogen activator in acute stroke – treatment with or without C1-esterase inhibitor

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F27283933%3A_____%2F18%3A00005670" target="_blank" >RIV/27283933:_____/18:00005670 - isvavai.cz</a>

Result on the web

<a href="http://dx.doi.org/10.14735/amcsnn2018csnn.eu2" target="_blank" >http://dx.doi.org/10.14735/amcsnn2018csnn.eu2</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.14735/amcsnn2018csnn.eu2" target="_blank" >10.14735/amcsnn2018csnn.eu2</a>

Result language

angličtina

Original language name

Orolingual bradykinin angioedema after tissue plasminogen activator in acute stroke – treatment with or without C1-esterase inhibitor

Original language description

Introduction: Plasminogen activator (tPA) may result in a life-threatening complication - bradykinin-induced angioedema (BiA). BiA can cause acute airway obstruction and lead to acute hypoxia. In the case of the occurrence of BiA, the main therapy is the administration of C1-esterase inhibitor (C1-INH), the routine treatment of corticosteroids and antihistamines is ineffective. The aim of this work is to present BiA treatment in two case histories - with and without C1-INH administration. Methods: In 2014-2016, tPA was administered in a total of 489 patients with ischemic stroke, and in two cases (0.4%), BiA occurred. Both patients used ACE (angiotensin converting enzyme) inhibitor in hypertension therapy. Results: Both corticosteroids and antihistamines were ineffective. In the case of patient No. 1 at our workplace, C1-INH was not available, in the patient we had to provide an acute airway orotracheal intubation. Based on this complication, we have modified our local protocol for ischemic stroke therapy, ie the availability of C1-INH. Patient # 2 was already treated with C1-INH, edema was quickly resolved and intubation was not necessary. Despite the dramatic situation, both patients complicated the treatment with a slight residual neurological deficit. Conclusion: In the case of failure of anti-angiologic therapy for angioedema, consideration should be given to BiA, especially if the patient is taking ACE inhibitor. Administration of C1-INH is fully indicated and the drug should be available at all tPA-treated sites.

Czech name

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Czech description

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Type

J_SC - Article in a specialist periodical, which is included in the SCOPUS database

CEP classification

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OECD FORD branch

30210 - Clinical neurology

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2018

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Ceska a Slovenska Neurologie a Neurochirurgie

ISSN

1802-4041

e-ISSN

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Volume of the periodical

81

Issue of the periodical within the volume

4

Country of publishing house

CZ - CZECH REPUBLIC

Number of pages

3

Pages from-to

478-480

UT code for WoS article

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EID of the result in the Scopus database

2-s2.0-85056125994