title: [Meningococcal purpura fulminans: treatment with recombinant protein C activator in 3 cases].
abstract: Purpura fulminans is a serious disease associated with high rates of morbidity and mortality. It usually leads to disseminated intravascular coagulation and septic shock related to reduced levels of protein C. Recombinant protein C (rPC) activator has been used successfully to inhibit this process. Intracranial hemorrhages are the most important, life-threatening adverse effects of treatment with rPC activator. We report 3 cases of patients with meningococcal purpura fulminans who developed septic shock and multiorgan dysfunction. They were treated with the protocol for septic shock, antibiotics and rPC activator from the time of admission, and improvement in hemodynamic dysfunction was observed within hours in all patients. All received platelet replacement transfusions. Subarachnoid bleeding complications occurred in 2 patients. One patient died 5 days after admission and 2 were discharged from the intensive recovery care unit 28 days after admission.
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital de Basurto, Bilbao, Bizkaia. unaisalinas@yahoo.es
authors.forename: U
authors.initials: U
authors.lastname: Salinas
authors.forename: J
authors.initials: J
authors.lastname: Unzueta
authors.forename: M A
authors.initials: MA
authors.lastname: Vidarte
authors.forename: M P
authors.initials: MP
authors.lastname: Rodrigo
authors.forename: J J
authors.initials: JJ
authors.lastname: Gómez
authors.forename: L
authors.initials: L
authors.lastname: Aguilera
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000188:drug therapy* / Q000382:microbiology*; D008297:Male; D008589:Meningococcal Infections / Q000188:drug therapy*; D008875:Middle Aged; D009842:Oligopeptides / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use*
chemical_list: D009842:Oligopeptides; D011994:Recombinant Proteins; C047135:protein C activator peptide