Protein C concentrate

Protein C concentrate (Human) Purpura fuhninans and coumarin-induced skin necrosis in patients with severe congenital protein C deficiency... 

Ceprotin (human protein C concentrate) is an additional protein-based anticoagulant now approved for general medical use. Protein C is a 62 kDa glycoprotein synthesized in the liver but... 

Coumarin-induced skin necrosis is a rare complication of oral anticoagulant therapy. Especially patients suffering from a rare and life-threatening blood disorder known as protein C deficiency are at risk. In these cases Protein C Concentrate (human). 

Antithrombin and activated protein C concentrates are available for the appropriate indications that include thrombosis in the setting of antithrombin deficiency and sepsis respectively. 

Prevention of recurrence of coumarin necrosis in patients with protein C deficiency, if treatment is necessary, could consist of transient simultaneous infusion of fresh frozen plasma (leading to a constant concentration of protein C) and heparin both before and at the first time of administration of an oral anticoagulant, associated or not with protein C concentrate (65,66). 

Lewandowski K, Zawilska K. Protein C concentrate in the treatment of warfarin-induced skin necrosis in the protein C deficiency. Thromb Haemost 1994 71(3) 395. 

A 5-year-old girl with acquired protein C deficiency had a stroke while taking valproate (69). The authors then measured protein C concentrations in 20 children taking valproate monotherapy and 20 children taking other anticonvulsants. There were significantly lower protein C concentrations in those taking valproate. Protein S and antithrombin III were not affected. Despite this, there is no known association between valproate therapy and a risk of thromboembolic disease, and the clinical relevance of this effect on protein C is not clear. 

Cefotazol cefmetazole Ceprotin protein C concentrate (human)... 

EU protein C concentrate anticoagulant Ceprotin Human protein C concentrate purified by MAb Purpura fulminans... 

Deficiencies of anticoagulant proteins can increase the risk of skin necrosis due to warfarin. In a 19-year-old man with protein C deficiency, recurrent (stuttering) priapism attributed to warfarin was complicated by skin necrosis, presumably because of paradoxical hypercoagulability [30" ]. Activated protein C concentrate can be used to treat such cases [31" ]. In another case, skin necrosis occurred on the pinna of an 82-year-old man with protein S deficiency after warfarin therapy for 2 weeks [32 ]. 

Rosenzweig N, Strauss T, Rubinstein M, Paret G, Kenet G. Activated protein C concentrate treatment for skin necrosis under warfarin treatment in severe genetic protein C deficiency combined with prothrombin mutation and factor V Leiden. Thromb Haemost 2009 101(2) 405-7. 

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