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Vol. 36, No. 2, 2007/2008
Issue release date: January 2009
Section title: Original Paper
Pathophysiol Haemos Thromb 2007–08;36:53–57
(DOI:10.1159/000173721)

Successful Protein C Concentrate Administration during Initiation of Oral Anticoagulation in Adult Patients with Severe Congenital Protein C Deficiency: Report of Two Cases

Imberti D. · Giorgi Pierfranceschi M.
Thrombosis and Haemostasis Center, Emergency Department, Piacenza Hospital, Piacenza, Italy

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 1/22/2008
Accepted: 2/15/2008
Published online: 1/5/2009

Number of Print Pages: 5
Number of Figures: 1
Number of Tables: 1

ISSN: 1424-8832 (Print)
eISSN: 1424-8840 (Online)

For additional information: http://www.karger.com/PHT

Abstract

Protein C (PC) is a vitamin K-dependent proenzyme with anticoagulant activity, and patients with congenital PC deficiency are at high risk for thrombotic episodes. In patients with PC deficiency, starting treatment with oral anticoagulant drugs is associated with a transient hypercoagulable state and clinically overt thromboembolic complications before reaching a full anticoagulant effect. This report describes a successful supplementation with PC concentrate in two adult patients with moderately severe PC deficiency during the initiation of oral anticoagulation and a course of therapeutic dose of low-molecular-weight heparin for acute venous thromboembolism. Plasma PC levels above 50% were observed in both patients and maintained during the entire supplementation treatment period with PC concentrate until a stable therapeutic anticoagulation level has been reached. These results have been obtained within a short time, thus allowing a safe administration of a loading dose of warfarin. No adverse reactions to the PC concentrate, i.e. skin necrosis and other thromboembolic complications, bleedings or allergic reactions, were observed. We conclude that PC concentrate seems to be effective for the prevention of thromboembolic complications and safe in patients with congenital PC deficiency while initiating oral anticoagulants.


  

Author Contacts

Dr. Davide Imberti
Thrombosis and Haemostasis Center, Emergency Department, Ospedale Civile
Via Taverna 49
IT–29100 Piacenza (Italy)
Tel. +39 0523 303 313, Fax +39 0523 303 315, E-Mail d.imberti@ausl.pc.it

  

Article Information

Received: January 22, 2008
Accepted after revision: February 15, 2008
Published online: January 05, 2009
Number of Print Pages : 5
Number of Figures : 1, Number of Tables : 1, Number of References : 19

  

Publication Details

Pathophysiology of Haemostasis and Thrombosis

Vol. 36, No. 2, Year 2007/2008 (Cover Date: January 2009)

Journal Editor: Rosing J. (Maastricht)
ISSN: 1424-8832 (Print), eISSN: 1424-8840 (Online)

For additional information: http://www.karger.com/PHT


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 1/22/2008
Accepted: 2/15/2008
Published online: 1/5/2009

Number of Print Pages: 5
Number of Figures: 1
Number of Tables: 1

ISSN: 1424-8832 (Print)
eISSN: 1424-8840 (Online)

For additional information: http://www.karger.com/PHT


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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