Multiple organ dysfunction syndrome in pediatric colchicine poisoning: a national cohort study from Türkiye

Colchicine poisoning has been associated with systemic toxicity, multiple organ dysfunction syndrome (MODS), and mortality. In the present study, the demographic, clinical, and laboratory characteristics of pediatric colchicine poisoning cases and the incidence of organ failure are investigated to identify potential risk factors associated with MODS.

Included in this retrospective multicenter cohort study were pediatric patients admitted to 28 tertiary-care pediatric intensive care units with a diagnosis of colchicine poisoning. Demographic data, clinical and laboratory findings, and clinical outcomes were extracted from medical records. MODS was defined as dysfunction involving at least two organ systems. Multivariable logistic regression analysis was performed to identify the variables independently associated with MODS.

Of the 150 patients included in the study, 40% were younger than 5 years and 52% were older than 13 years. Gastrointestinal symptoms were most prominent, with nausea and vomiting observed in 64.7%, abdominal pain in 36.7%, and diarrhea in 24%. Overall, 66% developed no organ failure, while single-organ failure occurred in 7.3% and 26.7% developed MODS. The coagulation system was most frequently affected (26%), followed by the hematological (19.3%) and immunological (18%) systems. Multivariable logistic regression analysis identified the baseline PRISM III score, ingested colchicine dose per kilogram of body weight, and initial sodium, creatinine, and aspartate aminotransferase (AST) levels as independent predictors of MODS.

MODS can develop at ingestion doses lower than 0.5 mg/kg, which have historically been considered safe. Higher ingested doses and elevated PRISM III scores were associated with MODS, although these findings are derived from retrospective observational data and should not be interpreted as causal or as direct clinical recommendations. Further prospective studies are needed to clarify relevant doses, interventions, and prognostic factors in pediatric colchicine poisoning associated with MODS.