Superwarfarin poisoning: challenges still remain

Gil, Ariadna de Genover; Suarez, Gabriel Manuel González; Puig, Carla Moret; Ganoza, Abelardo Hurtado

doi:10.1136/bcr-2021-248385

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…Some of the clinical manifestations of AR poisoning include systemic mucosal and organ bleeding, common hematuria, skin ecchymosis, gingival bleeding, gastrointestinal bleeding, epistaxis, and hemoptysis. [ 10 , 11 ] ARs inhibit the production of vitamin K by inhibiting the activity of vitamin K 2, 3-epoxide reductase. In addition, the glutamic acid residues of vitamin K-dependent coagulins cannot be carboxylated, thus affecting the activation of coagulation factor II, VII, IX, and X, making them unable to exert their coagulant activity.…”

Section: Discussionmentioning

confidence: 99%

Rodenticide poisoning leading to cerebral hemorrhage: A case report

He,

Wu,

et al. 2024

Medicine

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Rationale: Anticoagulant rodenticides (ARs) are a substantial fraction of murine types. AR poisoning causes bleeding from the skin, mucous membranes, and multiple organs. However, reports of AR-induced cerebral hemorrhage are scarce. Patient concerns: A 40-year-old male presented with dizziness, headache, and limb weakness for 5 days and with coagulopathy. Two days prior to the onset of these symptoms, the patient was exposed to dead mice. Diagnoses: Rodenticide intoxication-induced cerebral hemorrhage. Interventions: Vitamin K1 infusion, administration of dehydrating agents to reduce intracranial pressure, and correction of acid-base and electrolyte imbalances. Outcomes: After 9 days of treatment, the patient’s symptoms were relieved, and reexamination revealed that coagulation parameters returned to normal levels. The patient was eventually discharged for observation with oral vitamin K1. Conclusions: Rodenticide poisoning can lead to intracerebral hemorrhage, and treatment with vitamin K1 infusion is effective. Lesson: Rodenticide poisoning-induced cerebral hemorrhage is rarely reported. Because its symptoms are nonspecific, it is easy to miss the diagnosis or misdiagnose. When patients present with direct and indirect symptoms such as dizziness, headache, and limb weakness, rodenticide poisoning should be considered. Coagulation function and head computed tomography or magnetic resonance imaging examination should be performed at the earliest to confirm the diagnosis and provide timely treatment.

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Section: Discussionmentioning

confidence: 99%