1. [46-year-old woman with multiple hematomas and bleeding of the base of the tongue: phenprocoumon poisoning].
- Author
-
Kriz-Kozak K and Lämmle B
- Subjects
- Anticoagulants administration & dosage, Anticoagulants blood, Blood Coagulation Tests, Drug Overdose blood, Female, Hematoma blood, Hematoma diagnosis, Hemorrhagic Disorders blood, Hemorrhagic Disorders diagnosis, Humans, Middle Aged, Phenprocoumon administration & dosage, Phenprocoumon blood, Tongue Diseases blood, Tongue Diseases diagnosis, Warfarin administration & dosage, Warfarin blood, Warfarin poisoning, Anticoagulants poisoning, Drug Overdose diagnosis, Hematoma chemically induced, Hemorrhagic Disorders chemically induced, Phenprocoumon poisoning, Tongue Diseases chemically induced
- Abstract
A 46-year old nurse complaining of multiple hematomas including bleeding into the tongue was referred for hemostasis evaluation. A very low Quick percentage value, i.e. a severely prolonged prothrombin time with severely depressed vitamin K-dependent coagulation factors (FII:C, FVII:C, FX:C) and normal FV:C and fibrinogen level was found. In the absence of cholestasis, malabsorption and broad-spectrum antibiotic therapy, ingestion of vitamin K antagonists was suspected. Three years previously, she had been on oral anticoagulant treatment with phenprocoumon (Marcoumar) for postoperative pulmonary embolism. She denied having voluntarily ingested anticoagulant drugs. A high plasma level of coumarins was found. To exclude accidental ingestion, the patient's son living in the same household was tested as well. Surprisingly, a low level of coumarin was found also in his plasma. We suspect that the patient voluntarily intoxicated herself and gave a low dose of coumarin anticoagulant to her son as well.
- Published
- 1999
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