PMID- 36948989
OWN - NLM
STAT- MEDLINE
DCOM- 20230425
LR  - 20230501
IS  - 1532-8171 (Electronic)
IS  - 0735-6757 (Linking)
VI  - 67
DP  - 2023 May
TI  - Retropharyngeal hematoma mimicking angioedema after intravenous thrombolysis for 
      acute ischemic stroke.
PG  - 196.e1-196.e2
LID - S0735-6757(23)00132-8 [pii]
LID - 10.1016/j.ajem.2023.03.016 [doi]
AB  - Tissue plasminogen activator (tPA) is a cornerstone treatment for acute ischemic 
      stroke (AIS). Administration of tPA is not without risk, and can provoke life 
      threatening adverse reactions. Retropharyngeal hematoma (RPH) following tPA 
      administration has only been reported after tenecteplase (TNK) administration for 
      ST elevation myocardial infarction (STEMI). A 78 year old patient received tPA 
      for AIS. Following administration of tPA, this patient developed acute signs and 
      symptoms of what appeared to be a more well-known adverse reaction of tPA 
      administration - angioedema. After CT and laboratory findings, our patient 
      received cryoprecipitate for tPA reversal. Our case highlights a unique case of 
      RPH mimicking angioedema following tPA administration.
CI  - Copyright (c) 2023 Elsevier Inc. All rights reserved.
FAU - Jolley, Allison
AU  - Jolley A
AD  - Department of Pharmacy, Methodist University Hospital, 1265 Union Avenue, 
      Memphis, TN 38104, United States of America; Department of Clinical Pharmacy and 
      Translational Science, University of Tennessee Health Sciences College of 
      Pharmacy, 881 Madison Avenue, Memphis, TN 38163, United States of America.
FAU - McKnight, Madison
AU  - McKnight M
AD  - Department of Pharmacy, Methodist University Hospital, 1265 Union Avenue, 
      Memphis, TN 38104, United States of America.
FAU - Clark, Kacie
AU  - Clark K
AD  - Department of Pharmacy, Methodist University Hospital, 1265 Union Avenue, 
      Memphis, TN 38104, United States of America; Department of Clinical Pharmacy and 
      Translational Science, University of Tennessee Health Sciences College of 
      Pharmacy, 881 Madison Avenue, Memphis, TN 38163, United States of America. 
      Electronic address: Kacie.Clark@mlh.org.
LA  - eng
PT  - Case Reports
DEP - 20230312
PL  - United States
TA  - Am J Emerg Med
JT  - The American journal of emergency medicine
JID - 8309942
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
RN  - 0 (Fibrinolytic Agents)
SB  - IM
MH  - Humans
MH  - Aged
MH  - Tissue Plasminogen Activator/adverse effects
MH  - Fibrinolytic Agents/adverse effects
MH  - *Ischemic Stroke/drug therapy
MH  - *Stroke/drug therapy/chemically induced
MH  - Thrombolytic Therapy/adverse effects
MH  - Treatment Outcome
MH  - *Brain Ischemia/drug therapy
OTO - NOTNLM
OT  - Acute ischemic stroke
OT  - Retropharyngeal hematoma
OT  - Tissue plasminogen activator
OT  - tPA
COIS- Declaration of Competing Interest The authors whose names are listed immediately 
      below certify that they have NO affiliations with or involvement in any 
      organization or entity with any financial interest (such as honoraria; 
      educational grants; participation in speakers' bureaus; membership, employment, 
      consultancies, stock ownership, or other equity interest; and expert testimony or 
      patent-licensing arrangements), or non-financial interest (such as personal or 
      professional relationships, affiliations, knowledge or beliefs) in the subject 
      matter or materials discussed in this manuscript.
EDAT- 2023/03/23 06:00
MHDA- 2023/04/25 06:42
CRDT- 2023/03/22 23:12
PHST- 2023/02/19 00:00 [received]
PHST- 2023/03/05 00:00 [revised]
PHST- 2023/03/05 00:00 [accepted]
PHST- 2023/04/25 06:42 [medline]
PHST- 2023/03/23 06:00 [pubmed]
PHST- 2023/03/22 23:12 [entrez]
AID - S0735-6757(23)00132-8 [pii]
AID - 10.1016/j.ajem.2023.03.016 [doi]
PST - ppublish
SO  - Am J Emerg Med. 2023 May;67:196.e1-196.e2. doi: 10.1016/j.ajem.2023.03.016. Epub 
      2023 Mar 12.