Hemorrhagic State Due to Surreptitious Ingestion of Bishydroxycoumarin

Abstract

Surreptitious use of an anticoagulant drug poses a baffling diagnostic problem, since the symptoms may simulate those of a congenital coagulation defect, vitamin K deficiency or liver disease. The first case of a bleeding disorder resulting from surreptitious ingestion of a prothrombinopenic anticoagulant drug was described by Stafne and Moe¹ in 1951; subsequently, 8 additional cases were reported.^{2 3 4 5 6} In all 9, the correct diagnosis was established with great difficulty. A congenital clotting--factor deficiency was usually the initial clinical impression. In most cases the correct diagnosis was suspected when multiple clotting-factor deficiencies were found, corresponding to those resulting from ingestion of . . .