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Death following colchicine poisoning
I M McIntyre1, A R Ruszkiewicz, K Crump
1Victorian Institute of Forensic Pathology, South Melbourne, Australia.
Journal of Forensic Sciences
|January 1, 1994
Summary
Colchicine overdose caused severe gastrointestinal symptoms, bone marrow hypoplasia, and pneumonia. Histopathology revealed mitotic figures in the gut, confirming colchicine toxicity.
Area of Science:
- Toxicology
- Gastroenterology
- Hematology
Background:
- Colchicine is a medication used to treat gout and familial Mediterranean fever.
- Overdoses can lead to severe toxicity, affecting multiple organ systems.
Observation:
- A 45-year-old male presented with vomiting, nausea, and diarrhea after colchicine ingestion.
- During hospitalization, a dramatic decrease in white blood cell count was observed.
Findings:
- Postmortem examination revealed bilateral bronchopneumonia, bone marrow hypocellularity, and reduced hematopoietic cells.
- Histological analysis showed numerous metaphasic mitotic figures in the gastric and small bowel epithelia.
- Colchicine was quantified in antemortem plasma and postmortem blood and bile using high-pressure liquid chromatography.
Implications:
- This case highlights the severe and potentially fatal consequences of colchicine overdose.
- The histological findings of mitotic figures suggest colchicine's mechanism of action involves disruption of cell division.
- Early detection and quantification of colchicine are crucial for managing toxicity.