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Clinical outcomes after colchicine overdose: A case report
Mingjie Fu1,2, Jie Zhao1,2, Zhitao Li1,2
1Department of Surgical Intensive Care Unit, First Affiliated Hospital, College of Medicine, Zhejiang University.
Medicine
|July 27, 2019
Summary
Colchicine overdose can lead to severe multiple organ failure, even with a low ingested dose, especially in patients with impaired kidney or liver function. Early diagnosis and intervention are critical for improving outcomes in colchicine poisoning.
Area of Science:
- Toxicology
- Pharmacology
- Internal Medicine
Background:
- Colchicine inhibits cell division and intracellular transport by stabilizing microtubules.
- A lethal dose of colchicine is approximately 0.8 mg/kg; widespread distribution complicates elimination.
- Patients with liver or kidney dysfunction exhibit delayed colchicine metabolism, increasing poisoning risk.
Observation:
- A 56-year-old male with gout and chronic kidney disease ingested 12 mg of colchicine.
- The patient presented with symptoms consistent with colchicine overdose, including gastrointestinal, bone marrow, cardiac, and hepatic damage.
- Despite interventions including continuous renal replacement therapy and supportive care, the patient developed multiple organ failure and died.
Findings:
- Colchicine overdose led to rapid hematopoietic inhibition, gastrointestinal failure, and cardiac damage within 32 hours.
- Progressive deterioration occurred due to infection and circulatory instability, leading to respiratory failure.
- Death occurred approximately 132 hours after admission, highlighting the severe consequences of colchicine toxicity.
Implications:
- High colchicine levels cause extensive organ damage and failure due to broad tissue distribution.
- Prompt diagnosis and reduction of colchicine levels are crucial for patient prognosis.
- Colchicine poisoning must be considered in patients with compromised liver or kidney function, even with low-dose ingestion.
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