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Letters to the editor
Guidelines on pulmonary embolism
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The new guidelines for the practical approach to management of pulmonary embolism (PE) are clearly welcome to help all clinicians dealing with such patients.1 I would, however, like to take issue with the statement advising the administration of hydrocortisone in conjunction with streptokinase to reduce the risk of allergic complications.
Allergic reactions are a well recognised adverse effect of intravenous streptokinase treatment and are probably due to immediate hypersensitivity reactions mediated by IgE antibodies to streptokinase.2 The incidence …