A Rare Antinuclear Antibody Fluorescence Pattern Induced by Rodenticides: a Case Report

Warfarin and superwarfarins, which belong to anticoagulants, are also widely used as rodenticides worldwide. Cases of accidental ingestion of these kinds of rodenticides often occur, and the patients usually have clinical symptoms of various systemic bleeding which are, in serious cases, life threatening.

We reported a 12-year-old boy poisoned by superwarfarins. He was initially diagnosed with coagulation disorder induced by rodenticides and was treated with vitamin K. A month after the onset of the disease, the patient was further treated in our hospital. We improved his relevant laboratory tests and found that his antinuclear antibody (ANA) and anti-SSA antibodies were positive. After the patient was cured and discharged, the result of ANA turned negative four months later.

The ANA fluorescence pattern of the patient presented a rare cytoplasmic granular type with low titer, which appeared when the patient was poisoned and disappeared after cured. In the previously reported cases of rodenticides poisoning, ANA-positive individuals are rare, and this kind of fluorescence pattern has not been reported before.

During the diagnosis and treatment of anticoagulant rodenticides poisoning patients, the monitoring of coagulation function is important, but other laboratory tests should also be considered to avoid missing some suggestive positive results.