Internal Medicine (Tokyo, 1992) 2011-01-01

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

Yoshito Kamijo, Chie Sato, Kuniko Yoshimura, Kazui Soma

Index: Intern. Med. 50(22) , 2819-22, (2011)

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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.