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Assessment of 17 Pediatric Cases With Colchicine Poisoning in a 2-Year Period
Demet Alaygut1, Suar Caki Kilic, Ali Kaya
1From the Departments of *Pediatric Nephrology, †Pediatric Hematology, ‡Pediatrics, and §Pediatric Cardiology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
Insights
Pediatric colchicine poisoning can cause severe gastrointestinal symptoms and alopecia, but mortality is not observed in this case series. Early assessment and supportive care are crucial for managing colchicine toxicity in children.
Area of Science:
- Pediatric Toxicology
- Clinical Pharmacology
- Internal Medicine
Background:
- Colchicine is a medication commonly used for Familial Mediterranean Fever (FMF) and Behçet's disease.
- Colchicine poisoning in children can occur due to accidental or intentional overdose.
- Understanding the clinical manifestations and outcomes of pediatric colchicine poisoning is essential for effective management.
Purpose of the Study:
- To discuss the clinical effects, treatments, and outcomes of pediatric colchicine poisoning.
- To highlight the importance of early diagnosis and supportive care in managing colchicine toxicity.
- To raise awareness among clinicians about colchicine poisoning, especially in regions with a high prevalence of FMF.
Main Methods:
- Observational case series study.
- Retrospective evaluation of medical records of children (0-18 years) hospitalized for colchicine poisoning.
- Data collected from January 2010 to January 2012 at a Pediatric Intensive Care Unit.
Main Results:
- 17 children with colchicine poisoning were analyzed.
- Most cases involved accidental ingestion, with 82.4% being involuntary drug intake.
- Common symptoms included gastrointestinal complaints; alopecia and acute abdomen were observed in some cases. No mortality was reported.
Conclusions:
- Colchicine toxicity has a high mortality rate, necessitating rapid assessment and intervention.
- Clinicians should consider colchicine intoxication in the differential diagnosis for children presenting with relevant symptoms, particularly in endemic areas of FMF.
- Prompt supportive care in an intensive care setting is vital for improving outcomes in pediatric colchicine poisoning.
Aim:
The aim of the study is to discuss clinical effects, treatments, and outcomes of pediatric colchicine poisoning.
Method:
This study was designed as an observational case series study. The medical records of children aged between 0 and 18 years, who were hospitalized for colchicine poisoning at the Department of Pediatric Intensive Care Unit, Cumhuriyet University Faculty of Medicine, between January 2010 and January 2012, were retrospectively evaluated.
Results:
We presented 17 children with colchicine poisoning. The mean (SD, range) age of patients was 71.5 (69.19, 18-204) months. The period to apply to the hospital after taking the medications was 7.3 hours (7.97, 30 minutes-26 hours) on average. The use of colchicine was due to diagnosis of Familial Mediterranean fever (FMF) in the families of 8 patients, diagnosis of Behçet disease in 1 patient's father, diagnosis of Behçet disease in 1 patient herself, and diagnosis of FMF in 6 patients themselves. Thirteen patients had taken colchicine at the dose of less than 0.5 mg/kg known as subtoxic and 1 patient had taken colchicine at the dose of greater than 0.8 mg/kg, and doses taken by 3 patients were not known. Fourteen patients (82.4%) had involuntary drug intake. Fifty percent of them were symptomatic at the moment of application and all had gastrointestinal complaints. All patients were observed in intensive care unit upon first admission and received supportive care. One of patients showed total alopecia, one showed leucocytosis, and another one showed acute abdomen picture. None of the patients showed mortality.
Conclusions:
Mortality of colchicine toxicity is high and quick assessment is absolutely required. In regions where FMF is common and the use of colchicine is high, clinicians should pay attention to symptoms and findings related to colchicine intoxication and keep them in mind in differential diagnosis.
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