Vnitr Lek 1994, 40(1):32-35

[A fatal hemorrhagic condition after rodenticide ingestion].

P Dulícek, L Chrobák, K Podzimek, J Voglová: Oddĕlení klinické hematologie FN Hradec Králové.

The authors describe a fatal haemorrhagic condition in a 53-year-old man which developed after assumed ingestion of so-called "superwarfarins". Symptoms of intoxication with substances of the warfarin type include the sudden development of haemorrhagic diathesis, marked prolongation of INR and APTT with persisting pathological values of these tests after the usual substitution doses of vitamin K1. The fluctuation of INR and APTT values during repeated examinations is also striking. In the event of such a coagulation finding it is important to consider possible superwarfarin intoxication, even if it is difficult to provide direct evidence, as it is not possible to assess the ratio of vitamin K1 and K 1, 2, 3 epoxide.