TY  - JOUR
PY  - 2018//
TI  - Rat poisoning: a challenging diagnosis with clinical and psychological implications
JO  - Laboratory medicine
A1  - Simmons, Sierra C.
A1  - Taylor, Laura J.
A1  - Marques, Marisa B.
A1  - Williams, Lance A.
SP  - 272
EP  - 275
VL  - 49
IS  - 3
N2  - 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.<br><br>© American Society for Clinical Pathology 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.<p />  <p>Language: en</p>
LA  - en
SN  - 0007-5027
UR  - http://dx.doi.org/10.1093/labmed/lmx093
ID  - ref1
ER  -