Colchicine-associated Ring Mitosis in Liver Biopsy and Their Clinical Implications

Abstract

Colchicine is an alkaloid with antimitotic activity used to treat a variety of medical conditions. Colchicine toxicity can result in multiorgan failure and death. In recent years, the histopathologic features of colchicine toxicity in various organs that is, gastrointestinal tract, kidneys, salivary glands, muscle, and skin have been described. However, the histopathologic manifestations of colchicine in the liver have not been reported. We present the case of a 54-year-old man with transfusion acquired chronic hepatitis C and longstanding gout managed with colchicine. A liver biopsy performed showed changes consistent with chronic hepatitis C along with many scattered mitoses arrested in metaphase in the hepatocytes that have been referred to as “ring” mitoses. The current liver biopsy was compared with the biopsy from 7 years ago, which appeared similar, however, ring mitoses were absent. Ring mitosis have been associated with colchicine-mediated tissue injury in various other sites, and their presence is felt to represent colchicine-induced liver injury in this case.

Colchicine-Induced Hepatotoxicity

“…Liver biopsy in a patient with chronic hepatitis C who had been taking colchicine for more than 10 years presented with mildly elevated liver tests and loose stools revealed "ring" mitotic figures that were not present on a previous biopsy 7 years earlier when he was also taking the agent. 14 Colchicine is most toxic to highly proliferative tissues. It is unclear why ring mitoses were not initially present in this case and ours.…”

Investigation of the Effect of Phenylboronic Acid on Androgen-Dependent (LNCaP) and Androgen-Independent (PC3) Prostate Cancer Cells via MAP Kinases by 2D and 3D Culture Methods

“…The literature indicates that PBA and boric acid inhibit proliferation in cancer cell lines, including prostate cancer cells [17,19,27,56]. In addition to the known antimitotic effect of colchicine, it may cause an increase in proliferation [57]. It may be suggested that the proliferation increase in colchicine-treated LNCaP and PC3 cells might result from the compensatory effect caused by colchicine.…”

Liliaceae Juss.

“…Although teratogenic effects have not been a fi eld problem, they may be expected as cleft palate and craniofacial and other deformities have been noted in mice (Keeler 1972). A special characteristic in humans is the presence of ring mitosis in the liver (Kamath et al 2008). Bile preferentially and urine or gastric fl uids secondarily are the preferred biological fl uids for analysis, although even vitreous humor may be used (Deveaux et al 2004;Cheze et al 2006).…”