Haemodynamic Studies in Eight Cases of Acute Colchicine Poisoning

Abstract

<jats:p> 1 The authors performed haemodynamic studies in 8 cases of colchicine poisoning. The doses absorbed ranged between 9 and 160 mg (mean dose 39 mg). The haemodynamic study was performed between the 6th and 72nd h after intoxication, before and after plasma infusion (370 ml over a period of 20 minutes). </jats:p><jats:p> 2 Four patients had severe shock with decreased cardiac index (CI) and increased systemic vascular resistance (SVR). Four patients had a hyperkinetic state with increased CI and decreased SVR. The four patients with cardiac failure died, the others recovered. </jats:p><jats:p> 3 Haemodynamic study of acute colchicine poisoning is of therapeutic and prognostic interest. Hypovolaemia is always present. An initial decrease of cardiac performance is an index of severity with a lethal outcome. </jats:p>

Four children with colchicine poisoning

“…Sauder et a].10 reviewed haemodynamic findings in eight cases of acute colchicine poisoning. 10 The ingested doses ranged between 9 and 160 mg (mean dose 39 mg). Four patients had severe shock with decreased cardiac index and increased systemic vascular resistance.…”

Fatal Cardiovascular Collapse Following Acute Colchicine Ingestion

“…16 Sauder et al described 8 patients with acute colchicine poisoning managed with the assistance of invasive cardiovascular monitoring. 17 Of the 4 patients who died of cardiogenic shock, 2 died following oral ingestions of doses below 0.5 mg/kg (0.37 mg/kg and 0.41 mg/kg). In 1986, Hobson and Rankin reported a fatal case of a 15-year-old boy who ingested 18 mg of colchicine (0.4 mg/kg) and 4 g of quinine.…”

Colchicine-related death presenting as an unknown case of multiple organ failure

“…Colchicine deaths generally result from cardiovascular collapse and fatal dysrhythmias within the first 72 h (11,12). Hypovolemia and electrolyte disturbances resulting from gastrointestinal toxicity may significantly contribute to impaired cardiac performance (3).…”

“…Although no studies have shown a direct toxic effect to cardiac myocytes, colchicine is known to produce structural changes in skeletal muscle with corresponding enzyme elevations (3,13). Serum troponin I (TnI) is a highly specific marker of acute myocardial injury and many hospitals now use TnI as the sole cardiac-specific marker (11). Higher concentrations of TnI suggest greater degrees of myocardial necrosis and a greater risk of mortality (14,15).…”