Colchicine Overdose in a Suicidal Attempt
International Journal of Medical Toxicology and Forensic Medicine,
Vol. 9 No. 4 (2019),
11 November 2019
,
Page 265-270
https://doi.org/10.32598/ijmtfm.v9i4.26520
Abstract
Colchicine overdose is uncommon; however, it can cause serious adverse effects and even death. Colchicine inhibits microtubule polymerization, causing mitotic spindle disruption. Ingesting ˃0.5 mg of colchicine per kilogram bodyweight causes severe adverse effects and can even be fatal. Therefore, colchicine toxicity must be accurately monitored and managed.
In this case report, we described a 21-year-old woman who attempted suicide by the ingestion of an estimated 30 mg colchicine. She was admitted to the hospital due to severe abdominal and chest pain, vomiting, lethargy, and weakness. The patient was medicated with ondansetron, apotel, antibiotics, platelet transfusions, sodium phosphate, calcium gluconate, calcitriol, desmopressin acetate, Granulocyte-Colony Stimulating Factor (G-CSF), and sodium bicarbonate. Fortunately, through the appropriate medical treatment, the signs and symptoms of colchicine toxicity were relieved and the patient survived despite the high colchicine serum level.
- Colchicine
- toxicity
- Case
How to Cite
References
1. Rudolph SA, Greengard P, Malawista SE. Effects of colchicine on cyclic AMP levels in human leukocytes. Proceedings of the National Academy of Sciences of the United States of America. 1977; 74(8):3404-8. [DOI:10.1073/pnas.74.8.3404] [PMID] [PMCID]
2. Lev S, Snyder D, Azran C, Zolotarsky V, Dahan A. Severe hypertriglyceridemia and colchicine intoxication following suicide attempt. Drug Design, Development and Therapy. 2017; 11:3321-4. [DOI:10.2147/DDDT.S140574] [PMID] [PMCID]
3. Polat E, Tuygun N, Akca H, Karacan CD. Evaluation of the colchicine poisoning cases in a pediatric intensive care unit: Five year study. The Journal of Emergency Medicine. 2017; 52(4):499-503. [DOI:10.1016/j.jemermed.2016.08.019] [PMID]
4. Wasserscheid K, Backendorf A, Michna D, Mallmann R, Hoffmann B. Long-term outcome after suicidal colchicine intoxication in a 14-year-old girl: Case report and review of literature. Pediatric Emergency Care. 2013; 29(1):89-92. [DOI:10.1097/PEC.0b013e31827b5747] [PMID]
5. Niel E, Scherrmann JM. Colchicine today. Joint, Bone, Spine. 2006; 73(6):672-8. [DOI:10.1016/j.jbspin.2006.03.006] [PMID]
6. Rochdi M, Sabouraud A, Girre C, Venet R, Scherrmann JM. Pharmacokinetics and absolute bioavailability of colchicine after i.v. and oral administration in healthy human volunteers and elderly subjects. European Journal of Clinical Pharmacology. 1994; 46(4):351-4. [DOI:10.1007/BF00194404] [PMID]
7. Link LH, Bindels AJ, Brassé BP, Intven FA, Grouls RJ, Roos AN. Severe colchicine intoxication; always lethal?!? Netherlands Journal of Critical Care. 2014; 18(4):19-21.
8. Aghabiklooei A, Zamani N, Hassanian-Moghaddam H, Nasouhi S, Mashayekhian MJR. Acute colchicine overdose: Report of three cases. Reumatismo. 2013; 65(6):307-11. [DOI:10.4081/reumatismo.2013.720] [PMID]
9. Finkelstein Y, Aks SE, Hutson JR, Juurlink DN, Nguyen P, Dubnov-Raz G, et al. Colchicine poisoning: The dark side of an ancient drug. Clinical Toxicology. 2010; 48(5):407-14. [DOI:10.3109/15563650.2010.495348] [PMID]
10. Verne GN, Davis RH, Robinson ME, Gordon JM, Eaker EY, Sninksy CA. Treatment of chronic constipation with colchicine: randomized, double-blind, placebo-controlled, crossover trial. The American Journal of Gastroenterology. 2003; 98(5):1112-6. [DOI:10.1111/j.1572-0241.2003.07417.x] [PMID]
11. Yousuf Bhat Z, Reddy S, Pillai U, Doshi M, Wilpula E. Colchicine-Induced Myopathy in a Tacrolimus-Treated Renal Transplant Recipient: Case Report and Literature Review. American Journal of Therapeutics. 2016; 23(2):e614-6. [DOI:10.1097/MJT.0000000000000044] [PMID]
12. Mullins ME, Mullins M, Carrico EA, Horowitz BZ. Fatal cardiovascular collapse following acute colchicine ingestion. Journal of Toxicology: Clinical Toxicology. 2000; 38(1):51-4. [DOI:10.1081/CLT-100100916] [PMID]
13. Paschke S, Weidner AF, Paust T, Marti O, Beil M, Ben-Chetrit E. Technical advance: Inhibition of neutrophil chemotaxis by colchicine is modulated through viscoelastic properties of subcellular compartments. Journal of Leukocyte Biology. 2013; 94(5):1091-6. [DOI:10.1189/jlb.1012510] [PMID]
14. Robert A, Terkeltaub RA. Colchicine update. Seminars in Arthritis and Rheumatism. 2009; 38(6):411-9. [DOI:10.1016/j.semarthrit.2008.08.006] [PMID]
15. Cronstein BN, Molad Y, Reibman J, Balakhane E, Levin RI, Weissmann G. Colchicine alters the quantitative and qualitative display of selectins on endothelial cells and neutrophils. The Journal of Clinical Investigation. 1995; 96(2):994-1002. [DOI:10.1172/JCI118147] [PMID] [PMCID]
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