Evolution of thrombin formation and fibrinolysis markers, including thrombin-activatable fibrinolysis inhibitor, during severe meningococcemia.
A 17-year-old girl presented with Neisseria meningitidis sepsis, with evidence of disseminated intravascular coagulation. Substitution therapy with both antithrombin and protein C concentrates was initiated, leading to clinical and biological improvement. Sequential dosages were performed for biological markers including thrombin-activatable fibrinolysis inhibitor (TAFI). Substitution therapy with both antithrombin and protein C concentrates led to a clinical and biological improvement. Biological markers showed a decrease in thrombin generation and in plasminogen activator inhibitor 1 (PAI-1) and a return of TAFI to a normal value. Discontinuation of substitutive treatment was marked by a clinical relapse at 24 h, with thrombin generation and increase in PAI-1, while TAFI remained unchanged. This report shows the evolution of hemostasis markers during septic shock and provides new data concerning the effects of a substitutive therapy.
Fouassier
Marc
M
Service d'Hématologie Biologique, CHU Gabriel Montpied, Clermont-Ferrand, France. marc.fouassier@chu-nantes.fr
Moreau
Delphine
D
Thiollière
Fabrice
F
Frère
Corinne
C
Marquès-Verdier
Alain
A
Souweine
Bertrand
B
D000293:Adolescent; D015415:Biomarkers; D001777:Blood Coagulation / Q000502:physiology; D025901:Carboxypeptidase B2 / Q000378:metabolism*; D005260:Female; D005342:Fibrinolysis / Q000502:physiology*; D006801:Humans; D008589:Meningococcal Infections / Q000097:blood* / Q000503:physiopathology; D009345:Neisseria meningitidis; D018805:Sepsis / Q000097:blood / Q000382:microbiology; D012720:Severity of Illness Index; D013917:Thrombin / Q000378:metabolism*
D015415:Biomarkers; D025901:Carboxypeptidase B2; D013917:Thrombin