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Korean J Intern Med ; 29(4): 498-508, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25045298

RESUMEN

BACKGROUND/AIMS: Recently, many cases of vitamin K-dependent coagulopathy of unknown origin have been reported. Such patients lack any relevant family history and have no systemic disease, raising suspicion of superwarfarin intoxication. We evaluated individual risk factors causing coagulopathy and hemorrhagic symptoms in patients with suspected superwarfarin intoxication. In addition, we determined how to effectively treat vitamin K-dependent coagulopathy caused by suspected superwarfarin intoxication. METHODS: Seven patients with suspected superwarfarin intoxication who lacked any definitive history of rodenticide ingestion were included. Thirty-one patients initially diagnosed with rodenticide poisoning were also included. We performed a retrospective chart review of all subjects and examined clinical data including patient demographics and medical histories. RESULTS: Patients initially diagnosed with rodenticide poisoning were divided into two groups, one of which had a laboratory abnormality (prothrombin time [PT] > 13 seconds) and another group with PTs in the normal range. There was no significant difference between the two groups in any of age, gender, the extent of chronic alcohol consumption, the causative rodenticide, psychiatric problems, ingestion of drugs interacting with warfarin, the extent of intoxication, or the type of ingestion attempt. The albumin level of the former group was significantly lower than that of the latter group (p = 0.014). Furthermore, a significant difference between the two groups was evident in terms of simultaneous ingestion of rodenticide and alcohol (p = 0.023). CONCLUSIONS: Most patients with superwarfarin poisoning did not exhibit any complication. When such complications were evident, they were associated with serum albumin level and coingestion of rodenticide and alcohol.


Asunto(s)
4-Hidroxicumarinas/envenenamiento , Anticoagulantes/envenenamiento , Coagulación Sanguínea/efectos de los fármacos , Rodenticidas/envenenamiento , Sangrado por Deficiencia de Vitamina K/inducido químicamente , Vitamina K/sangre , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/sangre , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tiempo de Tromboplastina Parcial , Tiempo de Protrombina , República de Corea , Estudios Retrospectivos , Factores de Riesgo , Albúmina Sérica/metabolismo , Albúmina Sérica Humana , Sangrado por Deficiencia de Vitamina K/sangre , Sangrado por Deficiencia de Vitamina K/diagnóstico , Sangrado por Deficiencia de Vitamina K/terapia , Adulto Joven
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