Neurotoxic Consequences of Bromadiolone Exposure: A Case Report of Toxic Encephalopathy
International Journal of Medical Toxicology and Forensic Medicine,
Vol. 15 No. 03 (2025),
22 September 2025
,
Page 1-8
https://doi.org/10.22037/ijmtfm.v15i03.48995
Abstract
Background: Rat poisoning is often used as a method of murder in Indonesia.
Case Presentation: In this case, a woman died from bromadiolone intoxication caused by her ex-husband. Bromadiolone is an anticoagulant poison that works by inhibiting the action of vitamin K, causing bleeding and damage to central nervous cells as it reduces the carboxylase in the brain, causing lowered sulfatide synthetase, which is important in forming myelin sheaths.
Conclusion: Triad of asphyxia was found in external examination, and the widening of vessels as a sign of toxic encephalopathy was found in the examination. Bromadiolone was found in the remains of melon juice drunk by the victims.
- Neurotoxin
- Bromadiolone exposure
- Toxic encephalopathy
- Forensic medicine
How to Cite
References
Bullock J, Lynch A. Rodenticide Toxicity. Textbook of Small Animal Emergency Medicine [Internet]. 2024 June 22 [cited 2025 August 10];2:841–5. [Link]
Vandenbroucke V, Bousquet‐Melou A, De Backer P, Croubels S. Pharmacokinetics of eight anticoagulant rodenticides in mice after single oral administration. J Vet Pharmacol Ther. 2008 Oct 30;31(5):437–45. [DOI: 10.1111/j.1365 2885.2008.00979.x]
Silva C D', Krishna B. Rodenticide Poisoning. Indian Journal of Critical Care Medicine. 2019. [DOI: 10.5005/jp journals 10071 23318]
Mustafa M, Laely NH, Densiana F, Anggreani E, Pitra E. Netflix's Representation in the Case of' Cyanide Coffee'in the film'Ice Cold: Murder, Coffee, and Jessica Wongso: Critical Discourse Analysis Fairclough. ELS Journal on Interdisciplinary Studies in Humanities. 2024;7(4):516–31. [DOI: 10.34050/elsjish.v7i4.41834]
Isnaeni B. The role of forensic autopsy in pursuit of material truth in optical evidence for negative legal proof in the cyanide coffee murder case. Sinergi international journal of law. 2024;2(1):61–71. [DOI: 10.61194/law.v2i1.116]
Sikary AK. Homicidal poisoning in India: A short review. J Forensic Leg Med. 2019;61:13–6. [DOI: 10.1016/j.jflm.2018.10.003]
Finnberg A, Junuzovic M, Dragovic L, Ortiz-Reyes R, Hamel M, Davis J, Eriksson A. Homicide by Poisoning. American Journal of Forensic Medicine & Pathology. 2013;34(1):38–42. [DOI: 10.1097/PAF.0b013e31823d2977]
Gürger M, Vicdanli NH, Türkoğlu A, Börk T, Göçük V, Göktekin MÇ, Ateşçelik M, Gül E. Fatal Poisonings: Autopsy-Based Study. Bezmialem Science. 2023;11(1):79–84. [DOI: 10.14235/bas.galenos.94840]
Lihua L, Yuning W, Henghui H, Xiang L, Min J, Zehao L, Lianjie L, Qian L. Retrospective analysis of 217 fatal intoxication autopsy cases from 2009 to 2021: temporal trends in fatal intoxication at Tongji center for medicolegal expertise, Hubei, China. Front Public Health. 2023;11. [DOI: 10.3389/fpubh.2023.1137649]
Eddleston M. Poisoning by pesticides. Medicine. 2020 Mar;48(3):214–7. [DOI: 10.1016/j.mpmed.2019.12.019]
D’Silva C. Rodenticide Poisoning. Indian Journal of Critical Care Medicine. 2019;23(S4):0–0. [DOI: 10.5005/jp journals 10071 23318]
Dear JW. Poisoning. In: Clinical Biochemistry: Metabolic and Clinical Aspects. Elsevier; 2014. p. 787–807.
Dear JW. Clinical Biochemistry: Metabolic and Clinical Aspects. Third. London: Elsevier; 2014. [Link]
Feinstein DL, Akpa BS, Ayee MA, Boullerne AI, Braun D, Brodsky S V., Gidalevitz D, Hauck Z, Kalinin S, Kowal K, Kuzmenko I, Lis K, Marangoni N, Martynowycz MW, Rubinstein I, van Breemen R, Ware K, Weinberg G. The emerging threat of super-warfarins: history, detection, mechanisms, and countermeasures. Ann N Y Acad Sci. 2016 Jun 31;1374(1):111–22. [DOI: 10.1111/nyas.13085]
Kodali S, Rajendran T, Richard IN, Boyapati L, Wong ECC, Avezbakiyev B. Super-warfarin Exposure: An Important Uncommon Cause of Painless Bleeding. J Hematol. 2019;8(4):155–9. [DOI: 10.14740/jh538]
Revathi K, Yogananda M. Effect of bromadiolone on haematology, liver and kidney in Mus musculus. J Environ Biol. 2006;27(1):135–40. [Link]
Wang H, Deng L, Sun B, Xing C, Mao H, Wu B. Bromadiolone may cause severe acute kidney injury through severe disorder of coagulation: a case report. BMC Nephrol. 2024;25(1):303. [DOI: 10.1186/s12882 024 03746 0]
Lasmawan G dwi, Widiyanto T, Utomo B. Pengaruh Berbagai Jenis Kandungan Zat Aktif Dalam Racun Tikus Terhadap Jumlah Dan Waktu Kematian Tikus Mencit Putih (Mus Musculus Strain Albino) Tahun 2019. Poltekes Semarang. 2019;2–3.
Kalinin S, Marangoni N, Kowal K. The long lasting rodenticide brodifacoum induces neuropathology in adult male rats. Oxford University Press. 2017;1–35. [DOI: 10.1093/toxsci/kfx134]
Wang M, Yang Y, Hou Y, Ma W, Jia R, Chen J. Effects of bromadiolone poisoning on the central nervous system. Neuropsychiatr Dis Treat. 2017;13:2297–300. [DOI: 10.2147/NDT.S142375]
Li Q, Yu W, Qu Y, Wang JQ, Mao N, Kang H. Acute toxic encephalopathy following bromadiolone intoxication: a case report. BMC Neurol. 2021;21(1):2–5. [DOI: 10.1186/s12883 020 02034 2]
Sauko P, Knight B. Forensic Pathology. Fourth Edi. CRC Press; 2015. 461–73 p.
Yudianto A. Ilmu Kedokteran Forensik. Surabaya: Scopindo; 2020. 20 p. [Link]
Osterhoudt KC, Penning TM. Drug toxicity and poisoning. Goodman & Gilman's the pharmacological basis of therapeutics. 2011;12:73–87. [Link]
Zhou Y, Tong JL, Peng AH, Xu SY. Comparison of drug concentrations in blood and gastric lavage fluid before and after gastric lavage: A case report. World J Clin Cases. 2023;11(31):7680–3. [DOI: 10.12998/wjcc.v11.i31.7680]
Sastre C, Bartoli C, Baillif-Couniou V, Leonetti G, Pelissier-Alicot AL. Post Mortem Redistribution of Drugs: Current State of Knowledge. Curr Pharm Des. 2018;23(36). [DOI: 10.2174/1381612823666170622111739]
Menéndez-Quintanal LM, Matey JM, del Fresno González V, Bravo Serrano B, Hernández-Díaz FJ, Zapata F, Montalvo G, García-Ruiz C. The State of the Art in Post-Mortem Redistribution and Stability of New Psychoactive Substances in Fatal Cases: A Review of the Literature. Psychoactives. 2024;3(4):525–6. [DOI: 10.3390/psychoactives3040033]
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