How is WISN in protein C deficiency treated?

Updated: Jan 04, 2019
  • Author: Shamudheen Rafiyath, MD; Chief Editor: Perumal Thiagarajan, MD  more...
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WISN is a medical emergency that requires treatment as soon as it is recognized. Therapy consists of immediate discontinuation of warfarin, administration of vitamin K, and initiation of therapeutic doses of heparin. If the patient is protein C deficient, exogenous protein C should be administered, either in the form of fresh frozen plasma or, preferably, as purified protein C concentrate (Ceprotin) with the goal of expeditiously normalizing plasma protein C activity. [70]

In adult patients with protein C deficiency who have experienced WISN, dabigatran, rivaroxaban apixaban, or edoxaban have been used successfully for subsequent anticoagulation. A case report describes the effective and safe use of rivaroxaban in a teenage patient, with thrombin generation assays used to adjust the dosage. [71]

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