{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:14:46Z","timestamp":1760955286605},"reference-count":4,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1999,5]]},"abstract":"<jats:p>\n            <jats:italic>Background and Purpose<\/jats:italic>\n            \u2014Although alteplase, a recombinant tissue plasminogen activator (tPA), is structurally identical to endogenous tPA and therefore should not induce allergy, single cases of acute hypersensitivity reactions have been reported. Until now, specific antibodies against alteplase were not detected in blood samples obtained in these patients.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Case Description<\/jats:italic>\n            \u2014We report an anaphylactic reaction in a 70-year-old white female who was treated with intravenous alteplase for thrombolysis of acute ischemic stroke 160 minutes after onset of a right-sided hemiparesis. Thirty minutes after infusion of alteplase had been started, the patient suffered acute severe sinus tachycardia and hypotension, followed by cyanosis and loss of consciousness. The alteplase infusion was stopped, and following antiallergic therapy, tachycardia and hypotension resolved within 1 hour. The hemiparesis remained unaltered, but additional harm resulting from the hemodynamic complication was not observed. Serum samples analyzed with a radioimmunoprecipitation assay were negative for total antibodies to alteplase, but in a subsequent ELISA, both samples were positive for IgE antibodies to alteplase.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014The detection of specific IgE antibodies reactive with alteplase in this patient could provide the first evidence of an anaphylactic-type reaction to alteplase in man. Because previous exposure to alteplase can be excluded, the results suggest that this patient had preexisting antibodies that were cross-reactive with one or more epitopes of alteplase and therefore precipitated the anaphylactic-type reaction.\n          <\/jats:p>","DOI":"10.1161\/01.str.30.5.1142","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:10:52Z","timestamp":1308341452000},"page":"1142-1143","update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":44,"title":["Evidence of Anaphylaxy After Alteplase Infusion"],"prefix":"10.1161","volume":"30","author":[{"given":"Jobst","family":"Rudolf","sequence":"first","affiliation":[{"name":"From Klinik und Poliklinik fu\u0308r Neurologie der Universita\u0308t zu Ko\u0308ln (J.R., M.G., S.S., W.-D.H.), Ko\u0308ln, Germany, and Bioanalytical Technology, Genentech (W.S.P.), South San Francisco, Calif."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Grond","sequence":"additional","affiliation":[{"name":"From Klinik und Poliklinik fu\u0308r Neurologie der Universita\u0308t zu Ko\u0308ln (J.R., M.G., S.S., W.-D.H.), Ko\u0308ln, Germany, and Bioanalytical Technology, Genentech (W.S.P.), South San Francisco, Calif."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William S.","family":"Prince","sequence":"additional","affiliation":[{"name":"From Klinik und Poliklinik fu\u0308r Neurologie der Universita\u0308t zu Ko\u0308ln (J.R., M.G., S.S., W.-D.H.), Ko\u0308ln, Germany, and Bioanalytical Technology, Genentech (W.S.P.), South San Francisco, Calif."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Schmu\u0308lling","sequence":"additional","affiliation":[{"name":"From Klinik und Poliklinik fu\u0308r Neurologie der Universita\u0308t zu Ko\u0308ln (J.R., M.G., S.S., W.-D.H.), Ko\u0308ln, Germany, and Bioanalytical Technology, Genentech (W.S.P.), South San Francisco, Calif."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolf-Dieter","family":"Heiss","sequence":"additional","affiliation":[{"name":"From Klinik und Poliklinik fu\u0308r Neurologie der Universita\u0308t zu Ko\u0308ln (J.R., M.G., S.S., W.-D.H.), Ko\u0308ln, Germany, and Bioanalytical Technology, Genentech (W.S.P.), South San Francisco, Calif."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","first-page":"298","volume":"7","year":"1991","unstructured":"Massel D, Gill JB, Cairns JA. Anaphylactoid reaction during an infusion of recombinant tissue-type plasminogen activator for acute myocardial infarction. Can J Cardiol.. 1991;7:298\u2013302.","journal-title":"Can J Cardiol."},{"key":"e_1_3_1_2_2","first-page":"588","volume":"29","year":"1994","unstructured":"Okpara AU, Egbunike IG, Jackson DJ, Stewart K. Anaphylactoid reaction following infusion of tissue plasminogen activator. Hosp Pharm.. 1994;29:588\u2013590.","journal-title":"Hosp Pharm."},{"key":"e_1_3_1_3_2","first-page":"966","volume":"341","year":"1993","unstructured":"Purvis JA, Booth NA, Wilson CM, Adgey AAJ, McCluskey DR. Anaphylactoid reaction after injection of alteplase. Lancet.. 1993;341:966\u2013967.","journal-title":"Lancet."},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(87)90159-8"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.30.5.1142","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:21:01Z","timestamp":1715552461000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.30.5.1142"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,5]]},"references-count":4,"journal-issue":{"issue":"5","published-print":{"date-parts":[[1999,5]]}},"alternative-id":["10.1161\/01.STR.30.5.1142"],"URL":"https:\/\/doi.org\/10.1161\/01.str.30.5.1142","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[1999,5]]},"assertion":[{"value":"1998-09-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1999-01-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1999-05-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}