Fatal colchicine overdose: Report of a case and review of the literature

Milne, Scott; Meek, Patrick D.

doi:10.1016/s0735-6757(98)90228-5

Cited by 81 publications

(62 citation statements)

References 45 publications

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“…Although approximately 50% of circulating colchicine is bound to plasma proteins and the plasma half-life is short, colchicine is demonstrated in leukocytes nine days after its administration. 5,6 Although we performed plasmapheresis and leucopheresis, our second patient died.…”

Section: Discussionmentioning

confidence: 96%

Colchicine Intoxication in Children: Four Case Reports

et al. 2015

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Section: Discussionmentioning

confidence: 96%

Colchicine Intoxication in Children: Four Case Reports

et al. 2015

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“…It is an antimitotic agent belonging to the family of spindle poisons used in several inflammatory diseases like gout and Behcet's disease. Poisonings have been exceptionally reported in children [2]. Here, we describe an unusual colchicine poisoning in a young girl mimicking an acute surgical abdomen.…”

mentioning

confidence: 80%

Colchicine intoxication mimicking an acute surgical abdomen: report of a pediatric observation

Koraichi¹,

Ghannam²,

Tadili³

et al. 2012

Réanimation

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Colchicine is an alkaloid extracted from Colchicum autumnale and Gloriosa superba [1]. It is an antimitotic agent belonging to the family of spindle poisons used in several inflammatory diseases like gout and Behcet's disease. Poisonings have been exceptionally reported in children [2]. Here, we describe an unusual colchicine poisoning in a young girl mimicking an acute surgical abdomen.A 14 year-old girl, treated for Behcet's disease with colchicine, was referred for acute diarrhea and abdominal pain. She was conscious, afebrile, with the following vital signs: blood pressure: 92/58 mmHg, heart rate: 130 /min, respiratory rate: 22/min, and SpO2: 98% on room air. There was a slight abdominal guarding. Pulmonary and cardiac examinations were unremarkable. Peripheral pulses were symmetrical. Abdominal X-ray did not reveal pneumoperitoneum. Ultrasound examination showed no peritoneal effusion. Despite supportive management and ceftriaxone + metronidazole combination, her abdominal pain worsened and vomiting started. The patient was admitted to the operating room. Midline laparotomy found a few milliliters of peritoneal fluid. Peritoneal lavage with warm isotonic saline was performed. No significant surgical abnormality was observed. The patient was admitted to the pediatric intensive care unit (ICU). Weaning from mechanical ventilator was impossible because of persistent hypoventilation. She developed a progressive paralysis of lower and upper limbs as well as loss of deep tendon reflexes, in the absence of hypokalemia and rhabodmyolysis. Electromyography was normal. Bacteriological cultures were negative. Alopecia appeared on day 2 and pancytopenia was further assessed (platelets: 1 G/L, hemoglobin: 7 g/dl, and white blood cells: 2 G/L) with no abnormal coagulation test. Diagnosis of colchicine poisoning was suspected. Spontaneous neurological recovery was progressive allowing extubation on day 7. The patient disclosed having ingested 24 mg of colchicine (0.6 mg/kg) for a suicidal attempt following an argument with her family. She left the hospital on day 15 after full recovery with a psychiatric follow-up.Colchicine poisoning is rare in the western countries, representing 0.7% of all intoxications, but more common in the Mediterranean countries because of its wide prescription for periodic disease [2,3]. Colchicine is a soluble alkaloid, absorbed by the ileum, and partially metabolized by the liver cytochrome P450 3A4. Metabolites are excreted in the bile, while one fifth of colchicine is excreted in its active form by the kidneys [3]. Colchicine acts by binding reversibly to tubulin (half life: 20 hours), preventing its polymerization into microtubules, which blocks the mitotic spindle and interrupts cell proliferation [4,5]. Thus, colchicine toxicity mainly involve cells with rapid turnover including the gastro-intestinal (GI) epithelium and bone marrow cells [6].To our knowledge, the youngest reported colchicinepoisoned patient in the literature was 3-year old [7]. Only one fatal case in children has been repor...

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“…Fakat hem renal hem de hepatik hastalık mevcudiyetinde toksisite riski büyük oranda artmaktadır. 3 Kolşisinin nontoksik, toksik ve öldürücü dozları arasında net olarak ayrım yapılamamaktadır. Total 50-60 mg'lık (1 mg/kg) doz alımından sonra şiddetli toksik etkileri takiben sağkalım olabilirken, 0,5 mg/kg'ın altındaki dozların alımında bile kardiyojenik şok ve ölümle sonuçlanabilmektedir.…”

Section: Olguunclassified

Colchicine Intoxication : A Report of Two Cases

Zincircioğlu¹,

Köse²,

Özkarakaş³

et al. 2016

Turkiye Klinikleri J Case Rep

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180olşisin, alkaloid yapıda olan ve 150 yılı aşkın süredir gut hastalı-ğının tedavisinde kullanılan bir ilaçtır. Kolşisin ayrıca, ailevi akdeniz ateşi (AAA) hastalığında atakları önlemek amacıyla; primer biliyer siroz, amiloidoz ve kondiloma akuminata gibi birçok hastalığın tedavisinde de kullanılmaktadır.Kolşisin zehirlenmesi nadir görülmektedir. Ancak, terapötik dozlarda veya özkıyım amaçlı yüksek doz alımında ölümle sonuçlanabilen şiddetli toksik etkiler görülebilmektedir.Kolşisin İntoksikasyonu: İki Olgu Nedeni ile Ö ÖZ ZE ET T Kolşisin, çeşitli hastalıkları tedavi ve önleme amaçlı kullanılan özel bir ilaçtır. İntoksikasyonu nadir olmakla birlikte terapötik indeksi dardır ve fark edilmediği durumlarda yüksek mortalite ile ilişkilidir. Ciddi hücresel hasara ve çoklu organ fonksiyon bozukluğu ve yetmezliğine sebep olmaktadır. Klinik belirti ve bulgular latent periyodun sonrasında üç fazda görülür. Birinci fazda elektrolit ve sıvı imbalansı ile birlikte gastrointestinal bulgu ve belirtiler ön plandadır. İkinci fazda, beş ve yedinci günlere kadar olan dönemde görülmekte ve kalp yetmezliği, aritmi, kemik iliği depresyonu, böbrek yetmezliği, karaciğer hasarı, respiratuar distres ve koagülopati gibi yaşamı tehdit eden bulgular belirginleşmektedir. İyileşme fazı olarak bilinen sonuncu faz rebound lökositoz ve alopesi ile kendini göstermektedir. Bu çalışmada, kolşisinle özkıyım nedeni ile hastaneye getirilen 28 ve 33 yaşlarındaki iki kadın olgunun klinik özellikleri ve intoksikasyon sonuçları sunulmuştur.A An na ah ht ta ar r K Ke el li im me el le er r: : Kolşisin; intihar; aşırı doz A AB BS ST TR RA AC CT T Colchicine is a unique drug for the treatment and prevention of several diseases. Although intoxication is relatively uncommon, it has narrow therapeutic index and associated with a high mortality rate when it is unrecognized. The drug has serious cellular damage effects and may leads to multiple organ dysfunction and failure. Clinical signs and symptoms are seen in three phase after a latent period. In the first phase, majority of the clinical findings are gastrointestinal signs and symptoms with fluid losses and electrolyte imbalance. The second phase is manifested with lifethreatening findings like cardiac insufficiency, arrhythmias, bone marrow depression, renal failure, hepatic injury, respiratory distress, coagulopathy until the 5 th to 7 th days. The last phase that is known as recovery phase is marked by a rebound leukocytosis and alopecia. In this review, two different cases, 28-year-female and 33-year-female who had admitted to the hospital as suicide with colchicine are reported with clinical features and outcomes of intoxication.K Ke ey y W Wo or rd ds s: : Colchicine; suicide; overdose

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Fatal colchicine overdose: Report of a case and review of the literature

Cited by 81 publications

References 45 publications

Colchicine Intoxication in Children: Four Case Reports

Colchicine Intoxication in Children: Four Case Reports

Colchicine intoxication mimicking an acute surgical abdomen: report of a pediatric observation

Colchicine Intoxication : A Report of Two Cases

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