Fatal Colchicine Poisoning by Accidental Ingestion of Colchicum persicum

Abstract

Colchicine poisoning can occur not only by taking dosage form but also by ingesting a plant containing colchicine. A 39-year-old man presented to the emergency room with nausea, vomiting, and diarrhea 9 hours after ingestion of wild garlic. Symptoms attributed to food poisoning, and he received supportive cares and discharged. However, he was admitted to the hospital because of severe gastrointestinal presentations 4 hours later. He received treatments based on the diagnosis of acute gastroenteritis. The patient was in a fair condition during 30 hours of hospitalization until he suddenly developed respiratory distress and unfortunately died with cardiopulmonary arrest. The deceased body referred to our legal medicine center for determining cause of death and investigating possible medical staff malpractices. Postmortem examination, autopsy, macropathology and micropathology study, and postmortem toxicological analysis were performed. All results were submitted to the medical committee office for decision. The unknown cause of death was disclosed after determination of colchicine in the plant and botanical identification as Colchicum persicum. The committee determined the most probable cause of death as acute cardiopulmonary complications induced by colchicine poisoning and the manner of death as accidental. The medical staff was acquitted of the malpractice.

COVID-19: therapeutic misinformation and intoxications

“…It is safe when used in the range of therapeutic doses but taking a toxic amount of either drug or plant source can be fatal. Furthermore, the diagnosis of colchicine poisoning is sometimes challenging since it can be misdiagnosed as an infectious disease or food poisoning [22,23]. Even the plant containing colchicine (Colchicum Spp., dried seeds) can be purchased by online shopping.…”

Acute Colchicine Poisoning Causes Endotoxemia via the Destruction of Intestinal Barrier Function: The Curative Effect of Endotoxin Prevention in a Murine Model

“…Acute colchicine poisoning is uncommon, but it is associated with a high mortality rate. It is caused by either the accidental ingestion of colchicine-containing plants or excess administration of colchicine as a drug [6][7][8][9][10]. For instance, Colchicum autumnale closely resembles wild garlic (Allium ursinum) eaten as a wild vegetable.…”

“…For instance, Colchicum autumnale closely resembles wild garlic (Allium ursinum) eaten as a wild vegetable. It has thus been mistaken for this plant, resulting in poisoning deaths [6][7][8]. In previous case reports, acute colchicine poisoning has resulted initially in gastrointestinal effects lasting for approximately 24 h, whereas these initial effects may be followed by multiorgan failure or death from cardiogenic shock, usually occurring within 48-96 h [1].…”

Comments on "Fatal colchicine intoxication"

“…[ 3 ] Even though, commonly much lower amount of the active ingredient expected to exist in a plant than in a drug formulation such as tablet, the aforementioned colchicine containing plants are exceptions. [ 2 3 4 ]…”

“…It is recommended that the authors write the botanical name of the plant in its proper scientifically accepted style as follow: The genus name comes first, the species name comes later with a free space and without the middle dash, both italicized, and only capitalization of the first letter of the genus name. [ 3 4 ]…”