PROTEIN-C IN THE TREATMENT OF COAGULOPATHY IN MENINGOCOCCAL DISEASE

Objective: To evaluate the clinical and laboratory effects of the subs titution of protein C (PC) as an adjunct to conventional therapy in th e treatment of purpura fulminans associated with meningococcal sepsis. Design: case series. Setting: Medical and medical-surgical intensive care units of two university hospitals. Patients: Three patients with purpura fulminans and multiple organ failure caused by Neisseria menin gitidis. Intervention: Intravenous administration of PC concentrate (1 00 IU/kg every 6 to 8 hrs). Measurements and Main Results: The adminis tration of PC resulted in normal or above normal levels of the plasma PC activity in all patients. The laboratory and clinical parameters re flecting the severity of coagulopathy improved during the treatment, a s did peripheral ischemia and the clinical manifestations of multiple organ failure. No adverse events were noted. One patient died of cereb ral edema. Conclusion: The administration of PC had a beneficial effec t on coagulopathy and peripheral gangrene formation associated with me ningococcal disease and showed no adverse effects.