%0 Journal Article
%T Rat poisoning: a challenging diagnosis with clinical and psychological implications
%J Laboratory medicine
%D 2018
%A Simmons, Sierra C.
%A Taylor, Laura J.
%A Marques, Marisa B.
%A Williams, Lance A.
%V 49
%N 3
%P 272-275
%X Rat poisoning should be considered in the differential diagnosis of a patient presenting with signs and symptoms of vitamin K deficiency without a more likely explanation. However, confirming this diagnosis may be difficult due to the varying sensitivities of available assays. A 40-year-old Caucasian woman presented to our hospital with chronic abdominal pain, hematuria, and a history of diarrhea of unknown etiology, despite an extensive work-up. Her laboratory evaluation results were consistent with vitamin K deficiency. Because she reported that she had not ingested warfarin, rat poisoning was suspected; however, the results of the first assay were negative. A second specimen was sent to another reference laboratory with a more sensitive assay, and the diagnosis of brodifacoum poisoning was confirmed. The patient was treated with oral vitamin K. If a patient presents with unexplained signs and symptoms of vitamin K deficiency, toxicological evaluation should be performed and repeat testing may be warranted, depending on the sensitivity of the original testing method.
© American Society for Clinical Pathology 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Language: en
%G en %I Lippincott Williams and Wilkins %@ 0007-5027 %U http://dx.doi.org/10.1093/labmed/lmx093