Too much of a good thing: two cases of disseminated intravascular coagulation‐like coagulopathy in patients with decompensated cirrhosis after administration of Prothrombinex‐VF

A 50-year-old man with decompensated Child Pugh C cirrhosis (CP-C) (MELD-Na 25) presented with fevers. He was treated empirically for spontaneous bacterial peritonitis, with i.v. Ceftriaxone 2 g, diuretics and Pabrinex. At presentation, he had a deranged coagulation profile with an international normalised ratio (INR) of 2.2, prothrombin time (PT) of 26 s, activated partial thromboplastin time (APTT) 49 s and fibrinogen (clottable) 1.0 g/L. In preparation for a diagnostic paracentesis, 4000 units (25 IU/kg) of Prothrombinex-VF (a prothrombin complex concentrate (PCC)) and 10 mg i.v. vitamin K was administered.