PEDIATRICS Vol. 96 No. 1 July 1995, pp. 144-148
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Recombinant Tissue Plasminogen Activator Treatment in Two Infants With Fulminant Meningococcemia

Werner Zenz MD1, Wolfgang Muntean MD1, Siegfried Gallistl MD1, Gerfried Zobel MD1, and Hans M. Grubbauer MD1

1 Department of Pediatrics, Karl Franzens University of Graz, Graz, Austria

Fulminant meningococcemia defines a life-threatening disease with acute onset, severe septic shock, and progressive hemorrhagic necrosis of the skin. Despite advances in intensive care, the case fatality rate of this disease is still between 30% and 50%.1-5

Disseminated intravascular coagulation (DIC) with deposition of fibrin and histologically demonstrable widespread microvascular thromboses contributes significantly to the pathogenesis.6-9 Impairment of fibrinolysis caused by elevation of plasminogen activator inhibitor 1 (PAI-1), the physiologic inhibitor of tissue plasminogen activator, is part of these clotting abnormalities and has prognostic significance; the extent of elevation of PAI-1 is correlated to the development of shock, renal impairment, and mortality.10,11

Submitted on January 5, 1994
Accepted on September 23, 1994




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