Unsuspected Colchicine Overdose in a Female Patient Presenting as an Acute Abdomen

Abstract

We report a case of multi-system organ failure as a result of unsuspected colchicine overdose in a patient with known gout and bulimia nervosa. The patient had initially presented with mild gastrointestinal symptoms with rapid progression to fulminant hepatic failure and multiple organ dysfunction before the causative agent was identified. The patient survived with aggressive intensive care support and ongoing medical treatment. Physicians should be aware of the risk assessment based on the ingested dose, that the clinical presentation of colchicine in toxic doses may be nonspecific with high potential for severe morbidity or death and that survival may occur despite multiple organ failure requiring aggressive support.

Colchicine overdose: A South African experience, a case report

“…Specific treatment includes Granulocyte-Colony-Stimulating Factor (GCS-F) and Fragment-Antigen-Binding (Fab) antibodies. GCS-F assists “regeneration of suppressed bone-marrow” [ 6 ] by accelerating production of neutrophils within the bone marrow and preventing sepsis [ 1 ]. Fab fragment antibodies are the only treatment that specifically targets Colchicine toxicity; however, it is not produced commercially.…”

Assessment of 17 Pediatric Cases With Colchicine Poisoning in a 2-Year Period

“…There are acute abdomen cases, which are reported to be related to colchicine poisoning in the literature. 14,15 The point that should be emphasized especially in such cases is that colchicine poisonings can imitate acute abdomen and clinicians should have an eye out for this matter.…”

Emergency abdominal surgery and colchicine overdose

“…This is especially important for the surgeon because frequently he will be the first to evaluate a patient presenting with acute abdominal symptoms to the emergency department. [6]…”