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Notable pink excreta and severe myocardial suppression in superwarfarin (difethialone) intoxication.

Abstract
Patients rarely consult physicians before developing coagulopathy or bleeding in most reported cases of superwarfarin intoxication. A 57-year-old woman ingested red-dyed pellets of anticoagulant rodenticide containing difethialone and warfarin as well as tablets of nitrazepam. Although she presented to the hospital in a comatose state, notable pink-colored excreta hinted at the consumption of anticoagulant rodenticide, which led to the early diagnosis of superwarfarin intoxication. Supplementation of large doses of intravenous and oral vitamin K successfully prevented coagulopathy and bleeding. On the other hand, temporary and reversible myocardial suppression was extremely severe, and required the introduction of percutaneous cardiopulmonary support.
AuthorsYoshito Kamijo, Chie Sato, Kuniko Yoshimura, Kazui Soma
JournalInternal medicine (Tokyo, Japan) (Intern Med) Vol. 50 Issue 22 Pg. 2819-22 ( 2011) ISSN: 1349-7235 [Electronic] Japan
PMID22082896 (Publication Type: Case Reports, Journal Article)
Chemical References
  • 4-Hydroxycoumarins
  • Anticoagulants
  • Coloring Agents
  • Rodenticides
  • difethialone
  • Vitamin K
  • Warfarin
  • Nitrazepam
  • bromfenacoum
Topics
  • 4-Hydroxycoumarins (administration & dosage, toxicity)
  • Anticoagulants (administration & dosage, toxicity)
  • Cardiomyopathies (chemically induced, diagnosis, therapy)
  • Coloring Agents (administration & dosage)
  • Female
  • Humans
  • Intra-Aortic Balloon Pumping
  • Middle Aged
  • Nitrazepam (administration & dosage, toxicity)
  • Rodenticides (administration & dosage, toxicity)
  • Vitamin K (administration & dosage, therapeutic use)
  • Warfarin (administration & dosage, toxicity)

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