PMID- 2603454
OWN - NLM
STAT- MEDLINE
DCOM- 19900205
LR  - 20191029
IS  - 1042-9611 (Print)
IS  - 1042-9611 (Linking)
VI  - 23
IP  - 12
DP  - 1989 Dec
TI  - Streptokinase-induced anaphylaxis.
PG  - 984-7
AB  - Streptokinase is a thrombolytic agent used most commonly for the dissolution of 
      thrombi obstructing coronary arteries during acute myocardial infarction (MI). 
      Anaphylactic reactions induced by streptokinase occur rarely. We report the case 
      of a patient with acute MI who developed anaphylaxis shortly after the initiation 
      of an intravenous infusion of streptokinase. The patient became profoundly 
      hypotensive and developed an erythematous rash that spread rapidly to cover most 
      of his body. He required mechanical ventilation and the administration of 
      epinephrine for blood pressure support, which succeeded after dopamine and 
      norepinephrine had failed. Streptokinase-induced anaphylaxis is thought to be 
      mediated by immunoglobulin E (IgE), and patients who develop this adverse 
      reaction have been shown to have higher serum concentrations of IgE to 
      streptokinase than those who do not. Epinephrine is the agent of choice for the 
      management of hypotension associated with anaphylaxis. Little evidence exists to 
      support the routine pretreatment of patients who are to receive streptokinase 
      with corticosteroids and/or antihistamines. Streptokinase skin testing may be a 
      useful and accurate means of identifying patients at risk for 
      streptokinase-induced anaphylaxis. Further investigation is required to determine 
      the appropriateness of skin testing in streptokinase therapy.
FAU - Tisdale, J E
AU  - Tisdale JE
AD  - State University of New York, Buffalo.
FAU - Stringer, K A
AU  - Stringer KA
FAU - Antalek, M
AU  - Antalek M
FAU - Matthews, G E
AU  - Matthews GE
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - DICP
JT  - DICP : the annals of pharmacotherapy
JID - 8904338
RN  - EC 3.4.- (Streptokinase)
SB  - IM
CIN - DICP. 1990 May;24(5):546-7. PMID: 2343600
MH  - Anaphylaxis/*chemically induced/physiopathology
MH  - Humans
MH  - Injections, Intravenous
MH  - Male
MH  - Middle Aged
MH  - Streptokinase/administration & dosage/*adverse effects
EDAT- 1989/12/01 00:00
MHDA- 1989/12/01 00:01
CRDT- 1989/12/01 00:00
PHST- 1989/12/01 00:00 [pubmed]
PHST- 1989/12/01 00:01 [medline]
PHST- 1989/12/01 00:00 [entrez]
AID - 10.1177/106002808902301206 [doi]
PST - ppublish
SO  - DICP. 1989 Dec;23(12):984-7. doi: 10.1177/106002808902301206.