Intensive Care Medicine

, Volume 18, Issue 4, pp 202–205

Protein C and S deficiency in severe infectious purpura of children: A collaborative study of 40 cases

  • F. Leclerc
  • J. Hazelzet
  • B. Jude
  • W. Hofhuis
  • V. Hue
  • A. Martinot
  • E. Van der Voort
Originals

DOI: 10.1007/BF01709832

Cite this article as:
Leclerc, F., Hazelzet, J., Jude, B. et al. Intensive Care Med (1992) 18: 202. doi:10.1007/BF01709832

Abstract

We studied, in 40 children (mean age: 52 months) with severe infectious purpura, the relationships between protein C (PC) and protein S (PS) levels, and shock, disseminated intravascular coagulation (DIC) and outcome. We determined, on admission, PC antigen (ELISA) and activity (chromogenic test), and total PS (ELISA). Results were expressed as % of normal adult values. Statistical analysis was performed with SAS. Thirty children were in shock, 20 had DIC. All children with DIC, and 10 without DIC were in shock. Of 20 children who were in shock and had DIC, 7 died and 3 had an amputation. PC antigen was significantly decreased in shock children (p<0.05), in children with DIC (p<0.0005). and in non-survivors (p<0.05). PC activity was significantly decreased in shock children (p<0.05), in children with DIC (p<0.0005), and in non-survivors (p<0.005). Total PS was not decreased in shock children, but was significantly decreased in children with DIC (p<0.005), and in non-survivors (p<0.005). We conclude that PC and PS levels were decreased in our children, and that PC levels were significantly decreased in the presence of shock, DIC, and fatal outcome. PC and antithrombin III (AT III) supplementation, should be evaluated in children with severe infectious purpura with shock and DIC.

Key words

Infectious purpuraPurpura fulminansDisseminated intravascular coagulationProtein CProtein S

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • F. Leclerc
    • 1
    • 2
    • 3
    • 4
  • J. Hazelzet
    • 1
    • 2
    • 3
  • B. Jude
    • 1
    • 2
    • 3
  • W. Hofhuis
    • 1
    • 2
    • 3
  • V. Hue
    • 1
    • 2
    • 3
  • A. Martinot
    • 1
    • 2
    • 3
  • E. Van der Voort
    • 1
    • 2
    • 3
  1. 1.Department of Pediatric Intensive CareHôpital CalmetteLilleFrance
  2. 2.Department of HematologyHôpital CalmetteLilleFrance
  3. 3.Sophia Children's HospitalRotterdamThe Netherlands
  4. 4.Service de Réanimation InfantileHôpital CalmetteLilleFrance