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Adverse reaction to streptokinase with multiple systemic manifestations
I Montserrat1, J Altimiras, M Dominguez
1Department of Haematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Pharmacy World & Science : PWS
|September 22, 1995
Summary
Prosthetic valve thrombosis treatment with streptokinase can cause severe allergic reactions, including liver and kidney issues. Further research is needed to understand these adverse effects.
Area of Science:
- Cardiology
- Pharmacology
Background:
- A 47-year-old woman with a mechanical mitral valve prosthesis presented with exertional dyspnea.
- Diagnosis was prosthetic valve thrombosis, a serious complication of mechanical heart valves.
Observation:
- Treatment involved two intravenous streptokinase infusions.
- The patient developed chills, fever, tachycardia, and hypotension during the second infusion.
- Subsequently, she experienced jaundice, choluria, hepatic cytolysis, cholestasis, and renal insufficiency.
Findings:
- Extensive investigations for infectious or autoimmune causes were negative.
- All laboratory abnormalities resolved spontaneously within four weeks.
- The adverse events were attributed to an allergic reaction to streptokinase.
Implications:
- This case highlights the potential for severe, multi-systemic allergic reactions to streptokinase.
- Understanding the pathogenic mechanisms is crucial for managing patients with prosthetic valve thrombosis.
- Further studies are warranted to elucidate the mechanisms and guide clinical management.