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[Ingestion of a rodenticide with subsequent prolonged coagulopathy]
1Klinik für Innere Medizin und Angiologie, Katholisches Krankenhaus Hagen gemGmbH, Hagen. w.beermann@kkh-hagen.de
Background:
Free-selling rodenticides contain highly potent and long-acting coumarins that may cause severe and prolonged coagulopathies.
Case Report:
A 46-year-old male was admitted after accidental ingestion of a rodenticide with spontaneous hematomas and a nonmeasurable prothrombin time (International Normalized Ratio [INR]). He had a prolonged coagulopathy and required high doses of vitamin K(1) to normalize the prothrombin time. A dose reduction of vitamin K(1) was followed by a new rise in the INR.
Conclusion:
In cases of coagulopathy and suspicion of an intoxication with anticoagulants, an ingestion of rodenticides containing highly potent coumarins should be taken into account. Intoxications with these "superwarfarins" require high doses of vitamin K(1) given for several weeks.
Insights
Accidental ingestion of potent coumarin rodenticides can cause severe bleeding. Treatment requires high-dose vitamin K(1) for extended periods to manage prolonged coagulopathy from these "superwarfarins".
Area of Science:
- Toxicology
- Pharmacology
- Hematology
Background:
- Free-selling rodenticides contain highly potent, long-acting coumarins.
- These compounds can induce severe and prolonged coagulopathies.
Observation:
- A 46-year-old male presented with spontaneous hematomas and unmeasurable prothrombin time (International Normalized Ratio [INR]) after ingesting rodenticide.
- The patient experienced prolonged coagulopathy requiring high-dose vitamin K(1).
Findings:
- A dose reduction of vitamin K(1) led to a recurrence of elevated INR.
- This indicates a persistent anticoagulant effect necessitating extended treatment.
Implications:
- Suspected anticoagulant poisoning warrants consideration of coumarin-based rodenticide ingestion.
- Treatment of "superwarfarin" intoxication requires prolonged, high-dose vitamin K(1) therapy.
