Late Diagnosis of Severe Colchicine Intoxication

Abstract

A 4-year-old Turkish girl was referred to our hospital with the findings of encephalopathy and pancytopenia. She had a history of severe abdominal cramps and gastrointestinal bleeding. A confused state, muscle pain and weakness, erythema-bullous and erythema-nodosum-like skin lesions, and alopecia were observed at her hospitalization. All of these symptoms resolved on follow-up. On laboratory investigation severe thrombocytopenia and leukopenia, mild anemia, a moderate increase in aspartate aminotransferase and alanine aminotransferase levels were detected. After reevaluating her medical history, it was learned that she had accidentally taken 1.3 to 1.5 mg/kg of colchicine 3 to 4 days before her first hospitalization. The possibility of misdiagnosis of colchicine intoxication should be borne in mind, and pediatricians must be aware of its toxic effects, especially in areas where patients with familial Mediterranean fever are present.

Alopecia and Associated Toxic Agents: A Systematic Review

“…Multiorgan failure, including bone marrow suppression, occurs in the second stage, 1–7 days after ingestion. Individuals who recover experience the third stage, often characterized by transient alopecia between days 7 and 21 [38-40]. However, hair loss may not always be present.…”

“…Although the reported half-life of colchicine is 9–16 h, it may be longer at higher doses [38, 62]. Hair loss often begins 7–14 days after colchicine exposure, accompanied by gastrointestinal symptoms and leukocytosis [42].…”

Colchicine intoxication mimicking an acute surgical abdomen: report of a pediatric observation

“…The patient disclosed having ingested 24 mg of colchicine (0.6 mg/kg) for a suicidal attempt following an argument with her family. She left the hospital on day 15 after full recovery with a psychiatric follow-up.Colchicine poisoning is rare in the western countries, representing 0.7% of all intoxications, but more common in the Mediterranean countries because of its wide prescription for periodic disease [2,3]. Colchicine is a soluble alkaloid, absorbed by the ileum, and partially metabolized by the liver cytochrome P450 3A4.…”

“…Colchicine poisoning is rare in the western countries, representing 0.7% of all intoxications, but more common in the Mediterranean countries because of its wide prescription for periodic disease [2,3]. Colchicine is a soluble alkaloid, absorbed by the ileum, and partially metabolized by the liver cytochrome P450 3A4.…”

“…Colchicine is a soluble alkaloid, absorbed by the ileum, and partially metabolized by the liver cytochrome P450 3A4. Metabolites are excreted in the bile, while one fifth of colchicine is excreted in its active form by the kidneys [3]. Colchicine acts by binding reversibly to tubulin (half life: 20 hours), preventing its polymerization into microtubules, which blocks the mitotic spindle and interrupts cell proliferation [4,5].…”