[Recombinant human activated protein C in the treatment of children with meningococcal purpura fulminans].
Meningococcal purpura fulminans (MPF) produces high mortality and morbidity, despite appropriate standard therapy. Administration of recombinant human activated protein C (rhAPC) has been successfully applied in adults with MPF and pediatric studies are under way. We report three pediatric patients with MPF treated with rhAPC as compassionate therapy. In two of these patients, positive clinical and laboratory effects were observed and both children achieved full recovery. The remaining patient died after 36 hours from refractory multiorgan failure. No rhAPC-related adverse effects were detected. The reported cases highlight the usefulness of rhAPC in children with MPF at least as a rescue compassionate treatment. Further clinical trials are needed to better delineate its efficacy and administration schedule in children.
Servicio de Críticos, Intermedios y Urgencias Pediátricas, Departamento de Pediatría, Hospital Clínico Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, Santiago de Compostela, Spain. fedemartinon@movistar.com
F
F
Martinón-Torres
J María
JM
Iglesias Meleiro
M
M
Fernández Sanmartín
A
A
Rodríguez Núñez
J María
JM
Martinón Sánchez
D000293:Adolescent; D001779:Blood Coagulation Factors / Q000032:analysis; D002675:Child, Preschool; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011486:Protein C / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use*; D016896:Treatment Outcome; D014884:Waterhouse-Friderichsen Syndrome / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*
D001779:Blood Coagulation Factors; D005343:Fibrinolytic Agents; D011486:Protein C; D011994:Recombinant Proteins; C421124:drotrecogin alfa activated