Prolonged coagulopathy after brodifacoum exposure.

Area of Science:

• Toxicology
• Hematology

Background:

• Brodifacoum, a potent vitamin K antagonist, is a common ingredient in rodenticides.
• Exposure can lead to severe and prolonged coagulopathy, posing significant clinical challenges.

Observation:

• A 36-year-old male presented with severe coagulopathy of unknown etiology.
• Diagnosis of brodifacoum exposure was confirmed, necessitating extensive treatment with phytonadione (vitamin K1).

Findings:

• The patient experienced coagulopathy lasting approximately one year, refractory to standard and high-dose phytonadione therapy.
• Coagulopathy persisted even when brodifacoum levels were undetectable, suggesting long-term effects or complex interactions.
• Treatment involved prolonged, high-dose oral phytonadione, leading to significant cost implications.

Implications:

• This case underscores the need for sustained vigilance and potentially extended treatment protocols for brodifacoum poisoning.
• The economic burden of long-term phytonadione therapy may impact patient adherence and treatment outcomes.
• Further research into managing prolonged vitamin K antagonist-induced coagulopathy is warranted.