title: Clinical analysis of 12 patients caused by long-acting anticoagulant rodenticide occult poisoning.
abstract: OBJECTIVE
  To explore the clinical characteristics and diagnosis and treatment of occult poisoning caused by long-acting anticoagulant rodenticides.
  
  
  METHODS
  Records of 12 patients from July 2008 to April 2011 diagnosed as anticoagulant rodenticide occult poisoning, who had been misdiagnosed initially at other hospitals were analyzed retrospectively. Elements from the records included clinical symptoms and signs, laboratory findings for prothrombin time (PT) and activated partial prothrombin time (APTT), and initial misdiagnosis and treatment outcome at our hospital.
  
  
  RESULTS
  The clinical presentations of patients were insidious and serious, often presented as skin ecchymose, hematuria, menorrhagia and gastrointestine bleeding. Laboratory examinations showed prolonged PT and APTT; bleeding was controlled effectively by administoring vitamin K1 daily. There were statistical difference between PT and APTT before and after the treatment (P<0.01).
  
  
  CONCLUSIONS
  Coagulation disorders might be caused by the reduced acquisition in vitamin K dependent coagulation factors, which tends to be neglected due to a hidden medical history, delayed signs of poisoning, and various organs involved. A detailed patient history and systematic review may improve the diagnostic accuracy. Once diagnosed is made, vitamin K1 should be given as soon as possible.
authors.affiliation: Department of Emergency, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Cao
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.forename: Yueping
authors.initials: Y
authors.lastname: Zheng
mesh_terms: D000925:Anticoagulants / Q000506:poisoning*; D001778:Blood Coagulation Disorders / Q000139:chemically induced* / Q000175:diagnosis* / Q000188:drug therapy; D003692:Delayed-Action Preparations; D006801:Humans; D010314:Partial Thromboplastin Time; D011517:Prothrombin Time; D012378:Rodenticides / Q000506:poisoning*; D014812:Vitamin K / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D003692:Delayed-Action Preparations; D012378:Rodenticides; D014812:Vitamin K