[Analysis of thirteen cases with secondary coagulation disorder caused by raticide exposure].
OBJECTIVE
To summarize the clinical characteristics of secondary coagulation disorders caused by exposure to poison (raticide) in children and to investigate the diagnosis and corresponding treatment.


METHODS
The process of diagnosis, clinical characteristics, response to treatment and the prognosis were analyzed.


RESULTS
The main clinical manifestation was mucosal bleeding (66.6%), including epistaxis, gingival bleeding, hematomas and so on. All these children were previously well and had no history of bleeding. Activated partial thromboplastin time (APTT) and prothrombin time (PT) were prolonged, factor II was undetectable and the levels of factors VII, IX, and X were lower. The fibrinogen was normal. A raticide was detected in blood and urine of 13 children although 12 of the patients had no definite history of raticide ingestion. Prothrombin complex, fresh frozen plasma and vitamin K(1) were effective in these cases. However, 2 - 3 weeks later, 6 patients presented with recurrent bleeding.


CONCLUSIONS
For children with secondary coagulation disorders of unknown cause, intoxication of raticide should be considered. The administration of blood coagulation factors and vitamin K(1) are effective in early treatment, and the treatment period should be more than 2 months. The PT and APTT should be followed up. Vitamin K(1) should be stopped when PT and APTT are normal.
Department of Hematology & Oncology, Children's Hospital, Chongqing Medical University, Chongqing 400014, China.
Xing-hua
XH
Chen
Bi-tao
BT
Dai
Jie
J
Yu
You-hua
YH
Xu
Ying
Y
Xian
Yong-chun
YC
Su
Jian-wen
JW
Xiao
Xian-hao
XH
Wen
Xian-min
XM
Guan
D001778:Blood Coagulation Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012378:Rodenticides / Q000506:poisoning*; D010837:Vitamin K 1 / Q000008:administration & dosage / Q000627:therapeutic use*
D012378:Rodenticides; D010837:Vitamin K 1