Superwarfarin Rodent Poisons and Hemorrhagic Disease

Fang, Yirong; Ye, Dong-Qing; Tu, Chunyu; Zhang, Lijie; Ni, Jiajia; Shen, Jinyu; Huang, Zhaohui; Guo, Zhinan; Wang, Mingzhai; Zhu, Bao–Ping

doi:10.1097/ede.0b013e31826d0760

Cited by 6 publications

(4 citation statements)

References 6 publications

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“…Of note, 10 (71%) of the 14 deaths from case report data were associated with intracranial hemorrhage, and of the 10 reported cases of intracranial hemorrhage, only 1 (10%) survived. Within this closer review of LAAR exposures, brodifacoum was the most common offending agent-brodifacoum, 83/174 (48%); chlorophacinone, 24/174 (14%); LAAR not otherwise 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 specified, 67/174 (38%) [2][3][4][5][6][7][8]13,17,20,27,32,33,[38][39][40][41]43,[49][50][51]53,.…”

Section: Clinical Features and Diagnosis Of Laar Poisoningmentioning

confidence: 99%

“…Current guidelines recommend that if no symptoms or coagulation abnormalities Table 2 Signs and symptoms of LAAR poisoning (n = 174 reported cases) [2][3][4][5][6][7][8]13,17,20,27,32,33,[38][39][40][41]43,[49][50][51]53, Adverse event n (%) exist at 48 hours after exposure, patients should continue to be observed without treatment [13,81]. However, if compatible coagulation abnormalities coincide with serious bleeding, first-line hemostatic therapy involves immediate treatment with fresh-frozen plasma (FFP) and vitamin K 1 (phylloquinone/phytonadione).…”

Section: Treatment Of Laar Poisoningmentioning

confidence: 99%

“…Never intended for human use, cases of human poisoning can be dramatic and yet difficult to recognize. Longacting anticoagulant rodenticide poisoning is a global health issue with cases reported in Turkey, Croatia, Taiwan, China, Australia, Argentina, and the United States [2][3][4][5][6][7][8]. This review will provide the reader with a comprehensive understanding of LAAR poisoning by presenting the historical development of vitamin K antagonists, epidemiology, pharmacology, and clinical aspects of LAAR poisoning and its diagnosis and clinical management.…”

mentioning

confidence: 97%

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Long-Acting Anticoagulant Rodenticide (Superwarfarin) Poisoning: A Review of Its Historical Development, Epidemiology, and Clinical Management

Tran

2015

Transfusion Medicine Reviews

121

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Section: Clinical Features and Diagnosis Of Laar Poisoningmentioning

confidence: 99%

Section: Treatment Of Laar Poisoningmentioning

confidence: 99%

mentioning

confidence: 97%

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Long-Acting Anticoagulant Rodenticide (Superwarfarin) Poisoning: A Review of Its Historical Development, Epidemiology, and Clinical Management

Tran

2015

Transfusion Medicine Reviews

121

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“…[ 2 ] Bromadiolone intoxication in adults and children have been reported in China, with relatively mild clinical features, but this problem is rarely seen in fetuses. [ 3 ] Recognition of the severe coagulopathy in newborn resulting from bromadiolone poisoning is severely lacking. We report a neonatal case involving bromadiolone.…”

Section: Introductionmentioning

confidence: 99%

Massive neonatal intracranial hemorrhage caused by bromadiolone

Zhang

Tang

et al. 2017

Medicine

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Rationale:Bromadiolone, often called a super-warfarin, is a potent rodenticide with long half-life. Skin and mucosal bleeding is the most common clinical manifestations of its intoxication. Bromadiolone intoxications in adults and children have been reported, but this phenomenon is rarely seen in fetuses. This paper presents a case of neonate with massive intracranial hemorrhage mediated by bromadiolone intoxication, highlighting that the bromadiolone is potentially lethal to the fetus.Patient Concerns:The male neonate presented with poor respiratory effort, decreased muscle tone, and pallor at birth. He developed generalized seizures on day 1 of life. His mother suffered from bleeding of oral mucosa and the subsequent lab screening for toxicants showed a bromadiolone level of 126 ng/mL.Diagnoses:Laboratory tests revealed that prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT). A computed tomography (CT) of his head revealed a severe subdural hematoma, which lead to midline shift, bilateral intraventricular hemorrhage, and subarachnoid hemorrhage. Serum from cord blood was collected and screened for toxicants. The result returned with a bromadiolone level of 94 ng/mL.Interventions:The neonate was treated with vitamin K, fresh-frozen plasma, and red blood cells.Outcomes:His parents required termination of all treatments, and the neonate unfortunately died shortly after.Lessons:Through clinical experience from this case, we believe that bromadiolone can be passed down to the fetus via placenta. Neonatal intracranial hemorrhage caused by bromadiolone is rare but potentially lethal. Pregnant women should be informed of the serious side effects of bromadiolone and this poisonous reagent should be avoided in any period during pregnancy.

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Anticoagulant Rodenticides

Murphy¹

2018

Veterinary Toxicology

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Superwarfarin Rodent Poisons and Hemorrhagic Disease

Cited by 6 publications

References 6 publications

Long-Acting Anticoagulant Rodenticide (Superwarfarin) Poisoning: A Review of Its Historical Development, Epidemiology, and Clinical Management

Long-Acting Anticoagulant Rodenticide (Superwarfarin) Poisoning: A Review of Its Historical Development, Epidemiology, and Clinical Management

Massive neonatal intracranial hemorrhage caused by bromadiolone

Anticoagulant Rodenticides

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