@article{ref1,
title="46-year-old woman with multiple hematomas and bleeding of the base of the tongue: phenprocoumon poisoning",
journal="Therapeutische Umschau Revue Therapeutique",
year="1999",
author="Kriz-Kozak, K. and Lämmle, B.",
volume="56",
number="9",
pages="541-543",
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.<p /><p>Language: de</p>",
language="de",
issn="0040-5930",
doi="",
url="http://dx.doi.org/"
}