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[Prolonged anticoagulation following chlorophacinone poisoning]
J J Vogel1, P de Moerloose, C A Bouvier
1Département de médecine, Hôpital cantonal universitaire, Genève.
Schweizerische Medizinische Wochenschrift
|December 17, 1988
Summary
Chlorophacinone rodenticide poisoning requires prolonged vitamin K therapy for over seven weeks. This case highlights the need for extended clinical and laboratory monitoring in managing such intoxications.
Area of Science:
- Toxicology
- Pharmacology
Background:
- Rodenticide poisoning poses a significant public health concern.
- Chlorophacinone, an indanedione derivative, is known for its extended anticoagulant effect due to its antivitamin K properties.
Observation:
- A case of a young female deliberately ingesting 100 mg of chlorophacinone is presented.
- Initial prothrombin time was severely reduced (<10%), indicating significant coagulopathy.
- Prothrombin time normalized only after 7 weeks of high-dose vitamin K therapy, with recurrent drops upon vitamin K withdrawal.
Findings:
- High-dose vitamin K therapy was effective but required prolonged administration.
- Correlation between chlorophacinone plasma levels and prothrombin time variations was investigated using HPLC.
- Vitamin K-dependent factors (VII and X) normalized concurrently with prothrombin time.
Implications:
- This case underscores the necessity of prolonged clinical and laboratory follow-up for chlorophacinone rodenticide intoxication.
- Extended vitamin K administration is crucial for complete recovery and preventing relapse.
- Awareness of the prolonged antivitamin K effect of chlorophacinone is vital for healthcare providers treating rodenticide poisonings.