Colchicine-Induced Rhabdomyolysis

Abstract

Colchicine is derived from Colchicum autumnale and Gloriosa superba and is used to treat acute gout and familial Mediterranean fever (FMF). Musculoskeletal adverse effects range from myopathy to rhabdomyolysis. An 18-year-old woman, with a 2-year history of FMF treated with colchicine, took 9 colchicine pills (4.5 mg) to relieve severe abdominal pain. On the sixth day of hospitalization, the patient's condition worsened, and she died. As this was a case of fatal poisoning, a forensic autopsy was performed, and the cause of death was determined to be complications of muscle destruction due to colchicine intoxication with the findings of myocytolysis, positive antimyoglobin antibody staining kidney tubules. Colchicine toxicity begins with gastrointestinal symptoms. Multiorgan effects follow the gastrointestinal effects. Serious outcomes of colchicine toxicity are rhabdomyolysis, bone marrow suppression, and disseminated intravascular coagulation. In chronic diseases that require lifelong treatment with medications, adverse effects can arise with long periods of use. Our patient had been treated for FMF with colchicine for 2 years but took too many colchicine pills to relieve her severe abdominal pain. Warning patients about the effects of high doses of drugs and providing information about their toxic effects and what to do "in case" of overuse could be lifesaving.

Acute colchicine toxicity: A case report

“…Therefore, assessing indicators of muscle damage such as creatinine kinase, myoglobin, and lactic acid dehydrogenase is recommended. [8] In our patient, these markers were not monitored at 0, 12, 24 and 36 hours in intensive care.…”

Clinical, Laboratory, and Electrocardiographic Findings in Colchicine Toxicity: 10 Years of Experience

“…This can be considered a possible cause of azotemia in four of our patients who had CPK of more than 1,000 mg/dl and higher mortality. Arslan et al reported a case of colchicine poisoning with evidence of myocytolysis in autopsy ( 25 ) confirming the possible effect of the drug on myocytes. Colchicine has been known to induce myopathy in several other studies, as well ( 26 , 27 ).…”

Efficacy and safety of colchicine in inflammatory skin diseases: a retrospective, monocentric study in a large tertiary center

“…macrolides, has taken place. [44] Feared complications included anemia, neutropenia, rhabdomyolysis [45] as well as neuromyopathy. [46] Overdoses can be potentially lethal.…”