Protein C in the treatment of coagulopathy in meningococcal disease

OBJECTIVE: To evaluate the clinical and laboratory effects of the substitution of protein C (PC) as an adjunct to conventional therapy in the 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 meningitidis. INTERVENTION: Intravenous administration of PC concentrate (100 IU/kg every 6 to 8 hrs). MEASUREMENTS AND MAIN RESULTS: The administration of PC resulted in normal or above normal levels of the plasma PC activity in all patients. The laboratory and clinical parameters reflecting the severity of coagulopathy improved during the treatment, as did peripheral ischemia and the clinical manifestations of multiple organ failure. No adverse events were noted. One patient died of cerebral edema. CONCLUSION: The administration of PC had a beneficial effect on coagulopathy and peripheral gangrene formation associated with meningococcal disease and showed no adverse effects.