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January 1971

Meningococcemia and Treated With: Consumption Coagulopathy Heparin and Dextran 70

Author Affiliations


From the Department of Medicine, Massachusetts General Hospital, Boston. Dr. Ellman is now with the National Institute of Allergy and Infectious Diseases.

Arch Intern Med. 1971;127(1):134-136. doi:10.1001/archinte.1971.00310130138024

Several publications have recently emphasized the relationship between fulminant meningococcemia and consumption coagulopathy.1-3 Patients exhibiting meningococcal infection with intravascular coagulation and consumption of clotting factors have an extremely poor prognosis. Their course is usually characterized by irreversible shock. Treatment of the consumption coagulopathy with heparin has failed to alter the course of the irreversible shock and hemorrhagic tendency.1,2 Winkelstein et al3 have recently reported successful treatment of three patients with heparin sodium and dextran 70. These patients had laboratory evidence of consumption coagulopathy, but were free of purpura. This report concerns a patient with fulminant meningococcemia, shock, extensive purpura, and consumption coagulopathy, who was successfully treated with heparin and dextran 70. The use of dextran as a volume expander was necessitated by the refusal of the patient, a Jehovah's Witness, to accept transfusions or blood products. In addition, dextran was utilized because of antithrombotic properties which may

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