[Ingestion of a rodenticide with subsequent prolonged coagulopathy].
BACKGROUND
Free-selling rodenticides contain highly potent and long-acting coumarins that may cause severe and prolonged coagulopathies.


METHODS
A 46-year-old male was admitted after accidental ingestion of a rodenticide with spontaneous hematomas and a nonmeasurable prothrombin time (International Normalized Ratio [INR]). He had a prolonged coagulopathy and required high doses of vitamin K(1) to normalize the prothrombin time. A dose reduction of vitamin K(1) was followed by a new rise in the INR.


CONCLUSIONS
In cases of coagulopathy and suspicion of an intoxication with anticoagulants, an ingestion of rodenticides containing highly potent coumarins should be taken into account. Intoxications with these "superwarfarins" require high doses of vitamin K(1) given for several weeks.
Beermann
Werner
W
Klinik für Innere Medizin und Angiologie, Katholisches Krankenhaus Hagen gemGmbH, Hagen. w.beermann@kkh-hagen.de
D003374:Coumarins / Q000633:toxicity*; D006474:Hemorrhagic Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D011517:Prothrombin Time; D012378:Rodenticides / Q000633:toxicity*; D010837:Vitamin K 1 / Q000627:therapeutic use
D003374:Coumarins; D012378:Rodenticides; D010837:Vitamin K 1