Treatises
Clinical analysis of coumarins associated acquired vitamin K-dependent coagulation factor deficiency
Wu Shixin, Huang Yueqin
Published 2022-12-15
Cite as IMHGN, 2022, 28(24): 3551-3554. DOI: 10.3760/cma.j.issn.1007-1245.2022.24.032
Abstract
ObjectiveTo investigate the clinical characteristics and therapeutic effect of acquired vitamin K dependent coagulation factor deficiency caused by coumarins including overdosage of warfarin and rodenticide poisoning.
MethodsThe clinical data of 61 patients diagnosed in Department of Hematology, Donghai Branch, The Second Affiliated Hospital of Fujian Medical University from July 2013 to July 2022 were retrospectively analyzed. According to the type of coumarins, they were divided into group A (overdosage of warfarin, 34 cases) and group B (rodenticide poisoning, 27 cases). There were 19 males and 15 females in group A, aged 32-82 years, with a median age of 71 years old; in group B, there were 15 males and 12 females, aged 19-88 years, with a median age of 53 years old. The patients with severe bleeding symptom were given intravenous infusion of vitamin K1 10-60 mg/d supplemented with infusion of fresh frozen plasma. The changes of prothrombin time (PT) and activated partial thromboplastin time (APTT) before and after treatment and the detoxification time of vitamin K1 were detected. t test was used.
ResultsThe patients with overdosage of warfarin and bleeding in group A showed PT (111.58±46.50) s and APTT (100.02±20.58) s before vitamin K1 treatment, and PT (17.13±4.30) s and APTT (37.77±58.91) s after vitamin K1 treatment, with statistically significant differences (both P<0.01); warfarin should be suspended only in patients without bleeding. The patients with rodenticide poisoning in group B showed PT (102.13±75.34) s and APTT (84.02±48.24) s before vitamin K1 treatment, and PT (17.39±4.43) s and APTT (33.03±7.78) s after vitamin K1 treatment, with statistically significant differences (both P<0.01). The detoxification time of vitamin K1 in patients with overdosage of warfarin and bleeding was 1 day, and 1 month to 1 year in patients with rodenticide poisoning, and the detoxification time of vitamin K1 was different between the two (P<0.01).
ConclusionsWarfarin and rodenticide are coumarin anticoagulants. Vitamin K1 is effective in the treatment of overdose of warfarin or rodenticide poisoning. Because the purpose and half-life of the two drugs are different, the detoxification methods after overdose are not the same.
Key words:
Coumarins; Acquired vitamin K dependent coagulation factor deficiency; Warfarin; Rodenticide; Vitamin K1; Prothrombin time; Activated partial thromboplastin time
Contributor Information
Wu Shixin
Department of Hematology, Donghai Branch, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, China
Huang Yueqin
Department of Hematology, Donghai Branch, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, China
