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Superwarfarin poisoning in children: a prospective study.

S C Smolinske¹, D L Scherger, P S Kearns

¹Rocky Mountain Poison and Drug Center, Denver, CO 80204-4507.

|September 1, 1989

Summary

Accidental ingestion of superwarfarins in children can cause coagulopathy. Monitoring prothrombin time at 24 and 48 hours post-ingestion is crucial for detecting anticoagulation effects.

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Area of Science:

Toxicology
Pediatrics
Hematology

Background:

Accidental ingestion of long-acting anticoagulant rodenticides (superwarfarins) poses a risk to children.
Coagulopathy is a potential complication following exposure to these substances.

Purpose of the Study:

To determine the incidence, severity, onset, and duration of coagulopathy in children after ingesting superwarfarins.
To evaluate the predictive factors for abnormal prothrombin time.

Main Methods:

Prospective study of 110 children with accidental superwarfarin ingestion.
Prothrombin time (PT) measurements were obtained at 24 and 48 hours post-ingestion.
Clinical signs of toxicity were recorded.

Main Results:

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Eight out of 110 children (7.3%) showed prolonged prothrombin time ratio (≥1.2).
Abnormal PT values were more frequent at 48 hours (17.6%) than at 24 hours (1.9%).
Ingested amount and presence of dye did not predict abnormal PT; acute toxicity signs were transient.

Conclusions:

Superwarfarin ingestion can lead to coagulopathy in children.
Prothrombin time monitoring at both 24 and 48 hours is recommended for early detection.
Further studies are needed to determine the duration of PT prolongation.