University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin,
University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
WMJ. 2020 Jun;119(2):129-131.
Recent outbreaks of brodifacoum-induced coagulopathy resulting from the use of synthetic cannabinoids represents a growing public health concern. Brodifacoum is a commonly used and commercially available rodenticide that has anticoagulant properties. As new, unregulated synthetic cannabinoids enter the market, the potential for further outbreaks continues to rise.
We report a case of severe bleeding secondary to inhalation of synthetic cannabinoids contaminated with brodifacoum. The patient had been evaluated for several months of ongoing, unexplained vaginal bleeding and developed hematemesis and rectal bleeding 2 weeks after her last reported use.
There have been previous reports of hemorrhage after exposure to synthetic marijuana in rare cases, including an outbreak of severe bleeding and reported synthetic marijuana use in the Midwestern region of the United States in 2018.
While hemorrhaging after exposure to synthetic cannabinoids has been reported previously, we use this case to increase awareness of the potentially deadly exposures to brodifacoum from synthetic cannabinoids use in Wisconsin. By increasing awareness, emergency department physicians and state agencies can collaborate more effectively when responding in these cases.
最近，由于使用合成大麻素，出现了几起因食用溴敌隆而导致的凝血功能障碍的爆发，这引起了公众健康的关注。溴敌隆是一种常用的、市售的灭鼠剂，具有抗凝作用。随着新型、不受监管的合成大麻素进入市场，爆发的可能性继续上升。
我们报告了一例因吸入含有溴敌隆的合成大麻素而导致严重出血的病例。该患者曾因持续、不明原因的阴道出血接受了数月的评估，并在最后一次报告使用后 2 周出现呕血和直肠出血。
此前有过少数因暴露于合成大麻素而导致出血的报道，包括 2018 年在美国中西部地区爆发的一起严重出血和有报道称使用了合成大麻素的事件。
虽然此前曾有过暴露于合成大麻素后出现出血的报道，但我们通过此病例提高了对威斯康星州因使用合成大麻素而可能接触到溴敌隆的潜在致命风险的认识。通过提高认识，急诊科医生和州立机构可以在这些病例中更有效地合作。
