Lymphocytic angiitis following streptokinase therapy

A palpable, purpuric, nonpruritic eruption occurred in a 64-year-old man nine days after he received intravenous streptokinase therapy, which was successful in treating acute myocardial infarction. Perivascular mononuclear and eosinophilic infiltration was noted on routine staining of skin biopsy specimens: immune complexes, fibrin, and complement deposition in the skin microvasculature were demonstrated on immunofluorescent studies. These findings confirm the diagnosis of lymphocytic angiitis induced by streptokinase. Intermediate-type hypersensitivity reactions to streptokinase apparently have variable levels of severity. Clinicians who use streptokinase as a therapeutic agent should be aware of this potentially serious complication.