A case of self-ingestion of brodifacoum that resulted in spontaneous intra-abdominal haemorrhage, circulatory shock, rhabdomyolysis and acute renal failure is reported. Current knowledge and management of superwarfarin poisoning are discussed.
HadlerM., ShadboltR.Novel 4-hydroxycoumarin anticoagulants active against resistant rats.Nature1987; 253: 275–277.
2.
WeitzelJ.N., SadowskiJ.A., FurieB.C.. Surreptitious ingestion of a long-acting Vitamin K antagonist/rodenticide, brodifacoum: Clinical and metabolic studies of three cases.Blood1990; 76: 2555–2559.
3.
HollingerB.R., PastoorT.P.Case management and plasma half-life in a case of brodifacoum poisoning.Arch Inter Med1993; 153: 1925–1928.
4.
SwigarM.E., ClemowL.P., SaidiP., KimH.“Superwarfarin” ingestion. A new problem in covert anticoagulant overdose.Gen Hosp Psych1990; 12: 309–312.
ExnerD.V., BrienW.F., MurphyM.J.Superwarfarin ingestion.Can Med Ass J1992; 146: 34–35.
9.
KruseJ.A., CarlsonR.W.Fatal rodenticide poisoning with brodifacoum.Ann Emerg Med1992; 21: 331–336.
10.
HelmuthR.A., McClosskeyD.W., DoedensD.J., HawleyD.A.Fatal ingestion of a brodifacoum-containing rodenticide.Lab Med1989; 20: 25–27.
11.
BobcockJ., HartmanK., PedersonA.. Rodenticide-induced coagulopathy in a young child: A case of Munchausen syndrome by proxy.Am J Pediatr Hematol Oncol1993; 15: 126–130.
12.
PrendergastB.D., GeorgeC.F.Drug-induced rhabdomyolysis—mechanisms and management.Postgrad Med J1993; 69: 333–336.
13.
BechtoldH., TrankD., JahnchenE.Plasma vitamin K1-2,3-epoxide as a diagnostic aid to detect surreptitious ingestion of oral anticoagulant drugs.Lancet1983; 1: 596.
14.
KuijpersE.A., den-HartighJ., SavelkoulT.J., de-WolffF.A.A method for the simultaneous identification and quantitation of five superwarfarin rodenticides in human serum.J Anal Toxicol1995; 7: 557–562.
15.
WallaceS., PaullP., MashfordM.L.Covert self poisoning with brodifacoum, a “superwarfarin”.Aust NZ J Med1990; 20: 713–715.