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Abstract
Superwarfarin intoxications that induce profound and prolonged coagulopathy are being increasingly reported, to such an extent that it is becoming a comparatively common intoxication. However, there have been few reported cases of superwarfarin intoxication with an inadvertent cause or an unknown origin. A 58-year-old man with recurrent painless hematuria was found to have an acquired deficiency of vitamin K dependent clotting factors, and a large amount of vitamin K was required to correct the coagulopathy. He had no history of warfarin use or any exposure to rodenticides, but brodifacoum was detected in his serum. It is important for physicians to be aware that significant coagulopathy can occur secondary to superwarfarin intoxication, without any known exposure to substances that might induce this.
References
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Fig. 1.
The details of the treatment and the laboratory tests results obtained at the community hospital. After treatment with parenteral vitamin K and fresh frozen plasma (FFP), prothrombin time (PT) and activated partial thromboplastin time (aPTT) were shortened.
Fig. 2.
The details of the treatment and the laboratory tests results at our hospital. Note that prothrombin time (PT) and activated partial thromboplastin time (aPTT) were off-scale from October 23 to 25. However, after the administration of intravenous vitamin K and multiple units of fresh frozen plasma (FFP), PT and aPTT were shortened. Furthermore, PT and aPTT were prolonged after these treatments were stopped.
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