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      Antithrombin concentrate with plasma exchange in purpura fulminans.

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          Abstract

          OBJECTIVE: To report successful treatment of three patients admitted with purpura fulminans. DESIGN: Three cases with purpura fulminans: clinical presentation, laboratory findings, treatment, and outcome. SETTING: A seven-bed medical and general surgical Intensive therapy unit in a district general hospital. PATIENTS: Three young patients with clinical and laboratory findings of severe meningococcal sepsis and purpura. INTERVENTIONS: Early replacement therapy with antithrombin concentrate after a single initial plasma exchange, together with conventional antibiotic and supportive treatment. MEASUREMENTS AND MAIN RESULTS: All three cases had abnormal coagulation profile consistent with disseminated intravascular coagulation, adult respiratory distress syndrome, impaired renal function, and severe hemodynamic instability requiring inotropic support. Plasma antithrombin levels were measured in all cases. All patients survived and made a good recovery. CONCLUSIONS: We consider that correction of antithrombin to supranormal levels may have a beneficial effect on survival and outcome in purpura fulminans despite sustained low levels of protein C.

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          Author and article information

          Journal
          Pediatr Crit Care Med
          Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
          Ovid Technologies (Wolters Kluwer Health)
          1529-7535
          1529-7535
          Jul 2000
          : 1
          : 1
          Affiliations
          [1 ] Department of Anaesthetics (Dr. Munteanu), the Department of Renal Medicine (Dr. Bloodworth), and the Department of Haematology (Dr. Korn), Gwynedd Hospitals N.H.S. Trust, Ysbyty Gwynedd, Bangor, Gwynedd, North Wales.
          Article
          10.1097/00130478-200007000-00016
          12813293
          d67f128a-7d26-4279-9cc1-b82acc4fc1dc
          History

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