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Published:
Journal of Analytical Toxicology,
ISSN 0146-4760,
Volume 30, Issue 4, May 2006,
pp.281-286
CASE REPORT: Acute Bromadiolone Intoxication
Thomas Grobosch, Boris Angelow, Lena Schönberg,
and Dagmar Lampe
Berliner Betrieb für Zentrale Gesundheitliche Aufgaben (BBGes), Institute
of Toxicology—Clinical Toxicology and Poison Control Center Berlin, Clinical
Toxicology and Pharmacology, Oranienburger Str. 285, 13437 Berlin, Germany
A 55-year-old man came to the hospital with a bleeding wound on
his tongue. The coating of his tongue was green, and his sputum was red. Because
an increased international normalized ratio-value was measured, a blood sample
was sent to our laboratory with the suspicion of coumarin intoxication. Liquid
chromatography–electrospray ionization-mass spectrometry (LC–ESI-MS)
analysis confirmed the poisoning was by bromadiolone, with its maximum serum
concentration at 440 µg/L. The analysis of further samples resulted in
a calculated elimination half-life of 140 h. The analytical method described
was developed for the determination and quantitation of bromadialone using LC–MS.
This method is suitable for the simultaneous identification and quantitation
of 10 indirect anticoagulants in human serum, which include five superwarfarins
(brodifacoum, bromadiolone, difenacoum, difethialone, and flocoumafen) as rodenticides
licenced in Germany and five other vitamin K antagonists (acenocoumarol, coumatetralyl,
coumachlor, phenprocoumon, and warfarin). The method is based on an acidic (pH
4.2) liquid–liquid extraction followed by LC–ESI-MS analysis. Analytical
separation was carried out using an Atlantis C18 column (2.1 ¥ 20 mm, 3
µm). The mobile phase consisted of methanol/0.1% formic acid; the flow
rate was 0.6 mL/min, and the time needed for analysis was 5 min. The lower limit
of quantitation was 5 µg/L (signal-to-noise > 10).
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