Acute colchicine intoxication complicated with complete AV block

Area of Science:

• Cardiology
• Toxicology
• Pediatrics

Background:

• Colchicine is a medication used for rheumatic diseases.
• Colchicine poisoning symptoms include gastrointestinal distress and can lead to cardiotoxicity and mortality.
• Complete atrioventricular (AV) block is a rare but severe complication of colchicine intoxication.

Observation:

• A 9-year-old patient ingested a significant dose of colchicine.
• The patient presented with elevated liver enzymes, deteriorating kidney function, and cytopenia.
• Despite initial treatment, the patient's condition worsened, leading to coma and requiring mechanical ventilation.

Findings:

• The patient developed a complete heart block, necessitating temporary transvenous pacemaker implantation.
• This represents a previously unreported complication of colchicine intoxication in a pediatric patient.
• Cardiopulmonary arrest occurred post-pacemaker implantation, ultimately leading to the patient's death.

Implications:

• Colchicine cardiotoxicity is a primary cause of mortality in poisoning cases.
• Complete AV block in pediatric colchicine intoxication is exceptionally rare.
• Colchicine may exert a direct toxic effect on cardiac conduction pathways, warranting further investigation.