Acute colchicine overdose: report of three cases

Abstract

summaryIntentional acute toxicity by colchicine is not common but accompanies a high rate of complications and mortality. It is generally assumed to be an emergency in clinical toxicology. Rapid diagnosis and treatment can prevent death. The most common causes of death in this toxicity are acute cardiac failure, shock, and dysrhythmias with hematopoietic complications occurring in later stages. We report three cases of acute colchicine toxicity, two of which expired, with different presenting and ongoing signs and symptoms. We aimed to define the different possible clinical manifestations of the toxicity and review the probable treatments available for these patients.

Öldürücü Kolşisin Zehirlenmesi

“…As a consequence, damaged protein synthesis, blocked mitosis, reduced cellular activity, reduced exocytosis and endocytosis, disrupted cardiac myocyte contractility comprise due to effected cells metabolism (4). These mechanism results in multiple organ dysfunction (4).Acute cardiac failure, cardiac dysrhytmias, hematologic complications and shock are prevalent causes of mortality in colchicine toxicity (5).…”

Colchicine as an anti-inflammatory and cardioprotective agent

“…Severe cases of toxicity are often accompanied by acute systolic failure and arterial hypotension, which are associated with direct cardiotoxicity and are not related to underlying ischemic cardiomyopathy [122,123]. Bone marrow suppression with marked hypocellularity, thrombocytopenia, neutropenia and anemia accompany colchicine toxicity with progressive cardiovascular collapse and death [124][125][126]. In a series of 20 cases of intravenous colchicine toxicity (cumulative doses exceeding 2 --4 mg), which were reported to the US FDA, lethal outcomes were confined to disseminated intravascular coagulopathy following marked thrombocytopenia, leukopenia, pancytopenia, agranulocytosis and aplastic anemia [126].…”

Colchicine Intoxication Follow-Up in Intensive Care Unit: Case Report

“…Prerenal azotemi, miyoglobinüri ve kolşisi-nin renal tübüller üzerine direkt toksik etkisinden dolayı oligürik renal yetmezlik gelişmektedir. 16,17 Akut respiratuar distres sendromu (ARDS) gelişti-ğini bildiren raporlar da mevcuttur. 18 Kolşisin intoksikasyonlarında, 10. gün pek çok sistemde düzelme görülmektedir.…”

“…17 Kolşisin intoksikasyonu için antidot henüz kullanımda değildir. Fransa'da yapılan bir çalış-mada, keçilerde kolşisine karşı elde edilen antikorların ''fab'' parçacık enjeksiyonlarının deneysel olarak klinik tabloyu düzelttiği bildirilmektedir.…”