An Unusual Cause of Longstanding Diarrhea
Isairis Peralta1, Elizabeth Hubbard1, Laurentia Nodit1
1Pathology, University of Tennessee Medical Center/University of Tennessee Graduate School of Medicine, Knoxville, USA.
Cureus
|February 12, 2024
Summary
Colchicine toxicity can cause severe gastrointestinal issues and is often missed. Early histopathologic diagnosis of colchicine toxicity is crucial for improving patient outcomes.
Area of Science:
- Gastroenterology
- Toxicology
- Histopathology
Background:
- Colchicine is a medication with a narrow therapeutic index, frequently used for various medical conditions.
- Gastrointestinal symptoms are common side effects of colchicine therapy, occurring early or with long-term use.
- Unintentional colchicine toxicity is a significant clinical concern due to its high mortality rate if not promptly identified.
Observation:
- A 77-year-old female presented with dehydration, chronic diarrhea, and weight loss.
- Endoscopic examination revealed erythematous mucosa in the gastric antrum, with a normal duodenum and colon.
- Duodenal biopsies were essential for diagnosis.
Findings:
- Histopathologic analysis of duodenal biopsies showed partial villous atrophy.
- Elongated glands and numerous arrested ring mitoses were observed.
- These findings were consistent with colchicine toxicity.
Implications:
- Histopathologic recognition of colchicine toxicity can be challenging.
- Timely identification through biopsy is critical for patient management and improving outcomes.
- This case highlights the importance of considering colchicine toxicity in patients with unexplained gastrointestinal symptoms.
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