Open AccessDying to be Ill: Munchausen meets warfarin overdose
Author(s) -
Padmastuti Akella,
Vishal Jindal,
Sandhya Maradana,
Ahmad Daniyal Siddiqui
Publication year - 2019
Publication title -
journal of family medicine and primary care
Language(s) - English
Resource type - Journals
eISSN - 2278-7135
pISSN - 2249-4863
DOI - 10.4103/jfmpc.jfmpc_453_19
Subject(s) - medicine , warfarin , ecchymosis , coagulopathy , intensive care medicine , munchausen syndrome , poison control , anesthesia , medical emergency , surgery , injury prevention , atrial fibrillation , child abuse
Patients with severe coagulopathy related to vitamin K deficient proteins can be associated with surreptitious ingestion of vitamin K antagonists. Our patient presented acutely with extensive ecchymosis, gingival bleeding and hematuria. Her initial PT and PTT were prolonged and INR was >12.0. She denies contact with potent rodenticides or warfarin use. She is a healthcare professional. Within a week, she was readmitted with similar complaints and her warfarin levels were markedly high which raised the possibility of Munchausen syndrome. Warfarin overdose can lead to harmful consequences. Therefore, immediate diagnosis and prompt treatment is critically important to minimize morbidity and mortality.