History of the Use of Colchicum and related Medicaments in Gout: With Suggestions for Further Research

Hartung, Edward F.

doi:10.1136/ard.13.3.190

Cited by 109 publications

(54 citation statements)

References 25 publications

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“…Colchicine is an alkaloid in use since the 6th century AD to treat acute gouty arthritis [6]. Its role in the treatment of familial Mediterranean fever (FMF) and in the prevention of amyloidosis has been well established [2].…”

Section: Introductionmentioning

confidence: 99%

Near fatal acute colchicine intoxication in a child. A case report

et al. 2000

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Section: Introductionmentioning

confidence: 99%

Near fatal acute colchicine intoxication in a child. A case report

et al. 2000

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“…1 Colchicine interferes with cellular division by suppressing neutrophil activity in joints, thereby decreasing inflammation. It also affects other systems, such as the gastrointestinal (GI) tract, that have high cellular turnover rates.…”

Section: Ré Sumémentioning

confidence: 99%

Colchicine overdose with coingestion of nonsteroidal antiinflammatory drugs

Little

Tung²,

Truong

et al. 2014

CJEM

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Colchicine has a low therapeutic index. Its toxic effects generally occur at doses $ 0.5 mg/kg. We present the case of a 39-year-old female with toxicity following ingestion of 0.28 mg/kg. The patient presented to the emergency department (ED) with severe nausea, vomiting, and abdominal pain following an intentional multidrug ingestion that included colchicine, indomethacin, and zopiclone. Despite toxicologic management and supportive care, admission to the intensive care unit was required for clinical deterioration and symptom management. Shock and multiorgan failure resulted, with death occurring 52 hours postingestion. Although the toxic effects of colchicine are well documented, mortality caused by low doses is relatively uncommon. Management of toxicity consists of early diagnosis, decontamination, and supportive measures. Toxicity may be enhanced by drug interactions inhibiting metabolic enzymes or poor excretion due to renal failure. In this case, the ingestion of a nonsteroidal antiinflammatory drug and the associated volume depletion from the gastrointestinal effects of colchicine may have contributed to renal dysfunction, exacerbating the toxicity of colchicine. This ingestion of a relatively small dose of colchicine led to severe toxicity. Treatment options for colchicine toxicity are limited. RÉ SUMÉLa colchicine a un faible indice thé rapeutique. Ses effets toxiques se manifestent gé né ralement à des doses $ 0.5 mg/kg. Sera exposé le cas d'une femme de 39 ans chez qui des signes de toxicité sont apparus aprè s l'ingestion de 0.28 mg/kg de colchicine. La patiente a consulté au service des urgences pour de fortes nausé es, des vomissements et des douleurs abdominales à la suite de l'ingestion volontaire d'un cocktail mé dicamenteux, composé de colchicine, d'indomé thacine et de zopiclone. Malgré une prise en charge toxicologique et des soins de soutien, il a é té nécessaire d'admettre la patiente au service des soins intensifs pour une dé té rioration de l'é tat clinique et la prise en charge des symptô mes. S'en sont suivis un é tat de choc et une dé faillance multiorganique, qui se sont soldé s par la mort de la patiente 52 heures aprè s la prise des mé dicaments. Les effets toxiques de la colchicine sont bien connus, mais il est plutô t rare que de faibles doses de ce mé dicament entraînent la mort. La prise en charge de la toxicité comprend la pose pré coce du diagnostic, la dé contamination et des mesures de soutien. La toxicité peut ê tre aggravé e par les interactions mé dicamenteuses qui inhibent les enzymes mé taboliques ou par la faible excré -tion due à l'insuffisance ré nale. Dans le cas ici exposé , l'ingestion d'un anti-inflammatoire non sté roïdien et la dé plé tion du volume des liquides ré sultant des effets gastro-intestinaux de la colchicine ont pu jouer un rô le dans le dysfonctionnement ré nal, d'où l'intensification de la toxicité de la colchicine. Ainsi, la prise d'une dose relativement faible de colchicine a produit des effets toxiques graves, et les possibilité s de t...

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“…The earliest history of colchicine is confused due to the existence of several terms for botanicals which may or may not have been identical to C auturnnale, eg, hermodactyl, surinjan and ephemeron. This difficulty is evident in De Materia Medica, the herbal of Dioscorides (first century AD) (4), and has been well reviewed by Sharp (5) and Hartung (6).…”

Section: Co Lch Ici N Ementioning

confidence: 99%