Colchicine Poisoning: Case Report and Literature Review
Almas Ashraf, Ahmarin Zahid, Zaheer-ud-Din Babar and Amaad Fahim
Published: October 31, 2021.
Abstract
Colchicine is an active alkaloid that is commonly used for treatment of multiple diseases including gout, primary biliary cirrhosis and familial Mediterranean fever. Less commonly, it has been implicated in cases of fatal overdose owning to its narrow therapeutic index. Clinical presentation of colchicine poisoning follows a well described but swift course with gastrointestinal symptoms being the earliest manifestation. Death usually occurs either directly due to multiorgan failure or indirectly due to secondary sepsis. We report an extreme case of colchicine ingestion by a 22 years old female who intentionally ingested 45 to 50mg of colchicine. Six hours later she presented in local hospital where gastric lavage was performed. Four days later, on continual deterioration of her condition, she presented with poor prognosis in the tertiary care emergency. She exhibited symptoms of coagulopathy, respiratory distress, multiple organ failure and eventually suffered fatal cardiopulmonary collapse approximately 14 hours after admission. Use of Colchicine specific Fab fragments have been shown to reverse symptoms of Colchicine poisoning in experimental settings however they are not available for general use. Currently treatment options are limited to specific supportive measures.
Keywords: Colchicines; Poisoning; Multiple organ failure; Cardiopulmonary resuscitation; Respiratory distress syndrome