This observational study aimed at evaluating recent superwarfarin intoxication of Korean patients. K1 therapy quickly corrected long term PT and aPTT but hasty discontinuation triggered repeated bleeding diathesis in 6 individuals. Path of intoxication was unfamiliar Telmisartan or not certain among 8 of 10 individuals. Three individuals had a chance of environmental publicity taking into consideration their occupations: there could be intoxication by transdermal absorption or inhalation. Consequently high dosage and long term use of supplement K1 therapy is essential for effective cleansing. Further detailed analysis on environmental publicity and efforts to really improve option of the bloodstream level check in center are requested. Keywords: Superwarfarin Brodifacoum Supplement K Rodenticides Intro Attempted or unintentional superwarfarin exposure is becoming an important general public problem in Traditional western countries (1) as intoxication could cause long term bleeding diathesis and occasionally fatal outcomes. More than 10 0 instances of superwarfarin intoxication had been reported in 2008 towards the Poison Control Centers Toxic Publicity Surveillance System in america (2). In Korea just sporadic reviews of superwarfarin intoxication can be found without the systemic and complete investigations to the problem (3-5). We carried out an observational research of 10 instances of superwarfarin intoxication in Korea many of them broke out within a yr. MATERIALS AND Strategies Case record forms (CRF) for individuals with superwarfarin intoxication had been requested to 8 doctors from Oct 2009 to Apr 2010 by digital mails. Each one of the doctors was an going to hematologist from the individuals. A CRF included filling section for fundamental information of an individual: age group sex residence profession past background of disease and medicine background of anti-coagulants or anti-platelet agencies etc. Manifestations of bleeding had Telmisartan been surveyed and preliminary lab data including prothrombin period (PT) and turned on partial thromboplastin period (aPTT) had been collected. Outcomes of plasma blending check activity of coagulation serum and elements brodifacoum level check were also recorded. Flow-sheet of modification and treatment of lab data including PT and aPTT of every individual were gathered. The CRFs were analyzed by Hong J and Bang S-M and the full total results were reviewed with the other authors. Ethics declaration This scholarly research was performed for the general public great and had neither risk nor drawback for topics. Which means institutional Review Telmisartan Panel of Seoul Country wide Hospital Bundang Medical center permitted this research without acquisition of up to date consent (Acceptance number: B-1007-106-105). RESULTS Patient characteristics symptoms and diagnoses Seven male patients and 3 female patients Rabbit polyclonal to OPG. were reported in this survey. Their age ranged 37-83. Only one patient (patient 6) lived in a metropolitan city and outbreaks were nationwide. Most of the cases occurred since 2009 except for a male patient who diagnosed in 2007 (4). Two of them have been previously published as a case report (4 5 Reported bleeding events were oral mucosal bleeding (7 patients) hematuria (4 patients) easy bruising (5 patients) hematoma formation (5 patients) and epistaxis (3 patients). Patients uniformly showed prolonged PT and aPTT with decreased activity of vitamin K dependent coagulation factors. Plasma mixing test and activities of coagulation factors were evaluated in all of the patients and the same result were showed: correction of PT and aPTT and decreased activities of factors II VII IX and X. Serum brodifacoum test were requested in 5 of 10 patients by physicians and 4 of them with a positive result were definitely diagnosed as superwarfarin intoxication. One patient (patient 2) repeatedly denied any contact with rodenticides but she confessed to wanting to kill herself by taking rodenticides after an interview with a psychiatrist. One patient (patient 3) was initially witnessed ingestion of rodenticides by her neighbors so serum brodifacoum test was not performed. Environmental exposure was a possible cause in 3 patients (patients 4 7 and Telmisartan 10) as they worked as a horticulturist farmer and ragman respectively. Information for patient characteristics symptoms and diagnoses were summarized in Table 1. Table 1 Patients with superwarfarin intoxication in Korea Treatment Four patients (patient 1 3 4 and 6) failed to achieve sufficient correction of PT and aPTT.