Prolonged Coagulopathy Related to Superwarfarin Overdose
Authors: Sanjay Sarin, Hamid Mukhtar, Mohd A. Mirza
Journal: Annals of Internal Medicine (2005)

Letters18 January 2005Prolonged Coagulopathy Related to Superwarfarin OverdoseSanjay Sarin, MD, Hamid Mukhtar, MD, and Mohd A. Mirza, MDSanjay Sarin, MDFrom Geisinger Medical Center, Danville, PA 17822., Hamid Mukhtar, MDFrom Geisinger Medical Center, Danville, PA 17822., and Mohd A. Mirza, MDFrom Geisinger Medical Center, Danville, PA 17822.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-2-200501180-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Superwarfarin poisoning is a growing public health problem in the United States and affects people of all ages, primarily children (1). Physicians must have a high index of suspicion for superwarfarin exposure when patients have unexplained coagulopathy resistant to vitamin K replacement and fresh frozen plasma.Case Report: A 50-year-old man with a history of depression presented with hematuria, epistaxis, widespread ecchymosis of the skin, and guaiac-positive stool. He reported ingesting warfarin with suicidal intent. His hemoglobin level was 48 g/L (normal range, 137 to 165 g/L), his prothrombin time was greater than 50 seconds (normal ...References1. Chua JD, Friedenberg WR. Superwarfarin poisoning. Arch Intern Med. 1998;158:1929-32. [PMID: 9759690] CrossrefMedlineGoogle Scholar2. Hollinger BR, Pastoor TP. Case management and plasma half-life in a case of brodifacoum poisoning. Arch Intern Med. 1993;153:1925-8. [PMID: 8250654] CrossrefMedlineGoogle Scholar3. Weitzel JN, Sadowski JA, Furie BC, Moroose R, Kim H, Mount ME, et al. 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[PMID: 1984683] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Geisinger Medical Center, Danville, PA 17822. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCorrection: Prolonged Coagulopathy Related to Superwarfarin Overdose Metrics Cited ByFrom Rat Poison to Medicine: Medical Applications of Coumarin DerivativesLess Common Congenital Disorders of HemostasisApplication of a New Established System for Toxic Doses in Children With 4-Hydroxycoumarin Rodenticide IntoxicationAntidotes to coumarins, isoniazid, methotrexate and thyroxine, toxins that work via metabolic processesCoumarin anticoagulantsA 67-Year-Old Man with Epistaxis, Melena, Gross Haematuria and HaemarthrosisLess Common Congenital Disorders of HemostasisElevated International Normalized Ratio associated with long-term azithromycin therapy in a child with cerebral palsySuperwarfarin intoxication: hematuria is a major clinical manifestationSimultaneous bleeding and thrombosis in superwarfarin poisoningANTICOAGULANTS, THROMBOLYTIC AGENTS, AND ANTI-PLATELET DRUGSBromadiolone Poisoning: LCMS Method and Pharmacokinetic DataHaemarthrosis after superwarfarin poisoningLess Common Congenital Disorders of HemostasisBrodifacoum Poisoning with Toxicokinetic DataCoumarin anticoagulantsCorrection: Prolonged Coagulopathy Related to Superwarfarin OverdoseAnticoagulant Rodenticides 18 January 2005Volume 142, Issue 2Page: 156KeywordsAnticoagulantsBloodBlood plasmaCoagulopathyHemoglobinHemorrhageVitamin K ePublished: 18 January 2005 Issue Published: 18 January 2005 CopyrightCopyright © 2005 by American College of Physicians. 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