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Colchicine poisoning complicated by medulla oblongata myelinolysis: a case report

Wei Jiang1, Xuan-Yu Tan2, Jia-Ai Li1

  • 1Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China.

Annals of Palliative Medicine
|June 13, 2020
PubMed

Insights

Colchicine poisoning can cause medulla oblongata myelinolysis, a rare form of extrapontine myelinolysis (EPM), linked to hyponatremia. Prompt treatment can lead to good outcomes, though MRI lesions may persist.

Area of Science:

  • Neurology
  • Toxicology
  • Radiology

Background:

  • Extrapontine myelinolysis (EPM) is a rare neurological condition.
  • Medulla oblongata myelinolysis is an exceptionally rare manifestation of EPM.

Observation:

  • A 34-year-old male with gout ingested 15 colchicine pills, leading to severe vomiting and diarrhea.
  • The patient developed hyponatremia (serum sodium 118 mmol/L), which was treated, increasing to 129 mmol/L within 24 hours.
  • Brain MRI revealed a medulla oblongata lesion characteristic of myelinolysis.

Findings:

  • The patient was diagnosed with medulla oblongata myelinolysis and colchicine poisoning.
  • Methylprednisolone therapy was initiated, resulting in a good clinical outcome after 17 days.
  • Despite clinical improvement, the medulla oblongata lesion remained visible on MRI scans.

Implications:

  • This case highlights colchicine poisoning as a potential cause of hyponatremia-induced medulla oblongata myelinolysis.
  • It underscores the importance of correct hyponatremia management to prevent neurological complications.
  • Successful treatment outcomes are achievable even if MRI-detected brain lesions persist.
Keywords:
Colchicinecase reportdemyelinating diseasesmedulla oblongatamyelin sheath

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