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Korean J Hematol.  2009 Mar;44(1):53-57. 10.5045/kjh.2009.44.1.53.

A Case of Superwarfarin Intoxication without a Definitive History of Brodifacoum Exposure

Affiliations
  • 1Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea. stkim@chungbuk.ac.kr
  • 2Department of Internal Medicine, Chungbuk National University School of Medicine, Cheongju, Korea.
  • 3Chungbuk National University Medical Research Center, Cheongju, Korea.

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.

Keyword

Brodifacoum; Coagulopathy; Superwarfarin; Vitamin K

MeSH Terms

4-Hydroxycoumarins
Hematuria
Humans
Middle Aged
Rodenticides
Vitamin K
Warfarin
4-Hydroxycoumarins
Rodenticides
Vitamin K
Warfarin
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