Related Experiment Videos
Colchicine toxicity: distinct morphologic findings in gastrointestinal biopsies
C A Iacobuzio-Donahue1, E L Lee, S C Abraham
1Division of Gastrointestinal/Liver Pathology, Department of Pathology, Johns Hopkins University School of Medicine and Hospital, Baltimore, Maryland 21205-2196, USA.
The American Journal of Surgical Pathology
|July 28, 2001
Summary
Colchicine toxicity can cause fatal multiorgan failure. Gastrointestinal biopsies show distinct morphologic changes, including abnormal mitoses and apoptosis, aiding diagnosis of colchicine poisoning.
Area of Science:
- Gastroenterology
- Toxicology
- Pathology
Background:
- Colchicine is an alkaloid with antimitotic properties used for various conditions.
- Colchicine toxicity can lead to multiorgan failure and death.
- Histopathologic features of colchicine toxicity in gastrointestinal biopsies are not well-documented.
Purpose of the Study:
- To identify and report the histopathologic features of colchicine toxicity in gastrointestinal mucosal biopsies.
- To correlate these features with clinical evidence of colchicine toxicity.
Main Methods:
- Analysis of 21 gastrointestinal mucosal biopsies from 9 patients on oral colchicine therapy.
- Immunohistochemical staining for Ki67 proliferation antigen.
- Review of patient medical records, including history of gout and renal function.
Main Results:
- Distinct morphologic changes (metaphase mitoses, epithelial pseudostratification, loss of polarity) were observed in 100% of patients with clinical colchicine toxicity.
- Abundant crypt apoptotic bodies were present in 75% of toxic cases.
- Morphologic changes were most prominent in the duodenum and gastric antrum.
- Ki67 staining showed an expanded proliferating region in toxic cases.
- These features were absent in patients without clinical toxicity.
Conclusions:
- Colchicine toxicity presents with distinctive, recognizable morphologic features in gastrointestinal mucosal biopsies.
- Identification of these features is crucial for diagnosing potentially fatal colchicine poisoning.
- Gastrointestinal biopsies can serve as a diagnostic tool for colchicine toxicity.