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Prolongation of the prothrombin time after organophosphate poisoning
J C Murray1, F Stein, J C McGlothlin
1Section of Hematology-Oncology, Texas Children's Hospital, Houston 77030.
Insights
Organophosphate poisoning can transiently reduce factor VII activity, prolonging prothrombin time. Vitamin K corrected this, suggesting a link between organophosphate exposure and vitamin K-dependent clotting factors.
Area of Science:
- Toxicology
- Hematology
Background:
- Organophosphate poisoning is a significant clinical concern.
- Vitamin K-dependent coagulation factors play a crucial role in hemostasis.
Observation:
- A 14-month-old child presented with prolonged prothrombin time due to reduced factor VII activity following organophosphate poisoning.
- The prothrombin time normalized after administration of vitamin K.
Findings:
- This case suggests organophosphate poisoning can transiently impair vitamin K-dependent factor VII activity.
- The observed effect highlights a potential mechanism linking organophosphate toxicity to coagulopathy.
Implications:
- Routine coagulation screening, including prothrombin time and factor VII activity, may be warranted in patients with organophosphate poisoning.
- Understanding this interaction could improve patient management and outcomes in organophosphate intoxication.
Abstract:
Prolongation of the prothrombin time owing to a transient reduction in factor VII activity is described in a 14-month-old child with organophosphate poisoning. Correction after vitamin K administration suggested an organophosphate-related effect on vitamin K-dependent factor VII activity. Historically, coagulation screening has not been routinely recommended after organophosphate intoxications. We suggest, however, that routine screening in such patients may be important. A brief review of organophosphate poisoning and the unique features of our case are presented.