Report of a collective exposure to superwarfarin and literature review<br><b>Abstract in English</b>

Abstract

AIMS: To describe an episode of collective exposure to rodenticide of the superwarfarin group and to review the literature on the subject. CASES DESCRIPTION: About 40 people, including children, ate food contaminated with rodenticide in a public elementary school in Porto Alegre, Rio Grande do Sul. Thirty-four individual cases of accidental ingestion were reported to the Toxicology Information Center of Rio Grande do Sul. The case was widely publicized in the local press. After initial medical evaluation, 19 patients had nonspecific symptoms (like nausea, abdominal pain and dry mouth), while the other remained asymptomatic. All patients were monitored by controlling the prothrombin time. Three of them showed prolongation of prothrombin time and received vitamin K to reverse the coagulopathy. Local data and the literature review indicate that exposures to rodenticides of the family of superwarfarins are frequent. The toxic action of these agents occurs mainly on clotting factors produced by the liver and vitamin K-dependent. CONCLUSIONS: The patients did well, in accordance with what is described in the literature, which indicates that severe cases are rare. The monitoring and treatment followed the indication of vitamin K as antidote only in cases where clinical or laboratorial effect of the toxic agent is detected.