Alteplase-induced anaphylaxis accompanied with peripheral hematoma in a patient with acute cerebral infarction
10.3760/cma.j.issn.1008-5734.2018.03.013
- VernacularTitle:阿替普酶致急性脑梗死患者过敏反应并发外周血肿
- Author:
Jingliang ZHOU
1
;
Xiaodong GUAN
1
;
Xinjing WU
1
;
Binbin PENG
1
Author Information
1. 044000,山西省运城市中心医院质量控制办公室
- Publication Type:Journal Article
- Keywords:
Tissue plasminogen activator;
Stroke;
Anaphylaxis;
Hematoma
- From:
Adverse Drug Reactions Journal
2018;20(3):226-227
- CountryChina
- Language:Chinese
-
Abstract:
A 74-year-old male patient with hypertension was admitted to hospital because of aphasia and movement disorder of his right limb for 3 hours. He was diagnosed as acute cerebral infarction. Thrombolytic therapy with alteplase (1 mg/ml ) was given 1 hour and 17 minutes after admission. Intravenous injection of alteplase 6.48 mg was given firstly (within 1-2 minutes of completing the injection) and then 58.32 mg was administered intravenously via an infusion pump. About 10 minutes after treatment with alteplase,the patient suddenly developed pallor,drenching sweats,cold limbs,and unconsciousness;his blood pressure dropped from 169/89 mmHg to 112/68 mmHg. Alteplase-induced anaphylaxis was considered. Alteplase was immediately stopped and oxygen inhalation and liquid supplements were given. At the same time,dopamine,diphenhydramine,dexamethasone,and other anti-anaphylactic and anti-shock agents were immediately given. The next morning,the patient developed anemia,RBC 2.12×1012/L,Hb 66 g/L. That night,hematoma appeared in his deep muscle from the right hip (at the injection site)to thigh. The peripheral hematoma was considered to be induced by alteplase. On the 3rd day of admission,the patient developed cerebral palsy and was discharged by his family′s request.
