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[Meningococcal purpura fulminans: treatment with recombinant protein C activator in 3 cases]

U Salinas1, J Unzueta, M A Vidarte

  • 1Servicio de Anestesiología y Reanimación, Hospital de Basurto, Bilbao, Bizkaia. unaisalinas@yahoo.es

Revista Espanola De Anestesiologia Y Reanimacion
|November 13, 2007
PubMed

Insights

Purpura fulminans, a severe condition causing septic shock, can be treated with recombinant protein C (rPC) activator. While effective, this treatment carries risks, including intracranial hemorrhages, as seen in three meningococcal cases.

Area of Science:

  • Critical Care Medicine
  • Hematology
  • Infectious Diseases

Background:

  • Purpura fulminans is a severe condition linked to high morbidity and mortality.
  • It often results in disseminated intravascular coagulation and septic shock due to low protein C levels.
  • Recombinant protein C (rPC) activator is a therapeutic option to mitigate these complications.

Purpose of the Study:

  • To report three cases of meningococcal purpura fulminans treated with rPC activator.
  • To highlight the efficacy and potential adverse effects of rPC activator in severe sepsis.
  • To discuss the management of septic shock and multiorgan dysfunction in this context.

Main Methods:

  • Case series of three patients with meningococcal purpura fulminans.
  • Treatment included standard septic shock protocols, antibiotics, and rPC activator.
  • Platelet replacement transfusions were administered to all patients.

Main Results:

  • All patients showed rapid improvement in hemodynamic dysfunction within hours of treatment initiation.
  • Two patients developed subarachnoid bleeding complications.
  • One patient died, while the other two were discharged after 28 days.

Conclusions:

  • Recombinant protein C activator can rapidly improve hemodynamic function in purpura fulminans.
  • Intracranial hemorrhage remains a significant, life-threatening adverse event associated with rPC activator therapy.
  • Careful monitoring for bleeding complications is crucial in patients receiving rPC activator for purpura fulminans.

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