Identification of Patients at Risk for Anaphylaxis due to Streptokinase

Angioedema relacionado ao uso de estreptoquinase

“…In the case described, we were led to the diagnosis of secondary anaphylactic reaction to the use of streptokinase because the patient displayed a reaction within the shortest time, with angioedema, bronchospasms, hypertension and hemolysis 1 .…”

“…Sometimes the patient may be allergic to an entire drug class because the base of the immunological reaction is in certain common antigens to them, since the reaction to streptokinase which introduces antibodies of the types IgG and IgE against the antigens of the Streptococcus of the Beta hemolytic group 1 .…”

“…In general, allergies are prevalent in 1.7 to 18% of the patients submitted to thrombolysis using streptokinase, these reactions not being systemic. The anaphylaxis itself occurs in 15 out of 10000 patients [Dickewicz et al 1 and GISSI study 2 ] and is characterized by an acute reaction, with diffuse erythema, pruritus, urticaria, angioedema, bronchospasms, larynx edema, hyperperistalsis, hypertension, cardiac arrhytmia, isolated or together, hemolytic anemia. The majority of the symptoms develop rapidly (five to 30 minutes) after exposure.…”

Streptokinase and streptokinase card: questionnaire validation to evaluate knowledge among post‐STEMI patients in a Malaysian Tertiary Hospital

“…[6][7][8] Due to its highly antigenic nature, studies on antibody titres post-streptokinase injection. 9,10 recommend that streptokinase should not be readministered within a one-year period as it may cause severe allergic reaction(s) such as anaphylaxis and it may not be efficacious for subsequent STEMI event(s) within that time period. 5,10 In Hospital Tuanku Fauziah, our hospital setting, every STEMI patient who is administered streptokinase is counselled and issued with a streptokinase card (Figure 1) in the ward by a pharmacist.…”

“…These antibodies will eventually react to a subsequently administered dose of streptokinase, and therefore will stimulate either an allergic reaction or by neutralising the streptokinase, rendering it ineffective 6‐8 . Due to its highly antigenic nature, studies on antibody titres post‐streptokinase injection 9,10 . recommend that streptokinase should not be readministered within a one‐year period as it may cause allergic reaction(s) that can be as severe as anaphylaxis and may not be efficacious for subsequent STEMI event(s) within that duration 5,10 …”