Self-poisoning with colchicine

Abstract

ALTHOUGH colchicine poisoning by accident and therapeutic misadventure is well documented, ingestion for suicidal purposes has been recorded on relatively few occasions. This paper adds two further cases to the literature. Case reports Case 1Having frequently threatened to kill herself, a 16-year-old girl ate more than a dozen flowers of Colchictim autumnale (meadow saffron) at about midday on 3 September 1967. A few hours later she developed profuse vomiting and diarrhoea, which continued throughout the night.At 10.00 a.m. the following morning she was admitted to hospital in a state of profound shock She complained of intense thirst and abdominal pain and appeared severely dehydrated. Her heart rate was 132/min and systolic blood pressure 40 mm Hg. She was hypothermic (350C) and all tendon reflexes were depressed.Investigations: Hb 17-2 g/100 ml, PCV 575/s, WBC 40,800/mm3, platelets 152,000/mm.3, blood urea 64 mg/100 ml, capillary blood pH 7T28, std. bicarbonate 18-0 mEq/l, base excess -7 mEq/l, Pco2 40 mm Hg.Urethral catheterization produced a small quantity of urine of SG 1-020. There was heavy albuminuria.Intravenous fluids were given and the acidosis corrected with sodium bicarbonate. Metaraminol and noradrenaline were infused to maintain a systolic blood pressure of 90-95 mm Hg. Gastric lavage was not performed.Despite therapy, which included atropine, vomiting and diarrhoea continued and by 4.00 p.m. she had passed only 10 ml urine, of SG 1-010. The blood urea had risen to 84 mg/100 ml, but the urine urea concentration was only 120 mg/100 ml. Her respiratory rate was now 50/min, with a minute volume

Colchicine-induced toxicity in a heart transplant patient with chronic renal failure

“…A dose-related adverse effect of colchicine is Colchicine-induced toxicity 829 myelosuppression, most notably neutropenia. Other manifestations of colchicine toxicity include renal failure, hepatic damage, polyneuropathy, myopathy, rhabdomyolysis and cardiovascular effects including heart failuar and ventricular arhythmias (16)(17)(18)colchicine have been reported to be 7 to 60 milligrams (19) and dosages of 0.5 to 0.8 mg/kg may be fatal (20,21). Because of the large apparent volume of distribution, rapid tissue distribution, and high affinity binding at intracellular sites, colchicine is not effectively removed by hemodialysis.…”

Treatment of Severe Colchicine Overdose with Colchicine-Specific Fab Fragments

“…stead to hemodynamic collapse and cardiac arrhythmia. 2,4,[19][20][21][22][23][24][25][26] The mechanism of hemodynamic failure is uncertain 3 but may be related to binding of the drug to microtubules in myocardial cells 27-30 that play a part in various functions of heart cells. [27][28][29][30][31][32][33][34] Colchicine has also been shown to impair intrinsic myocardial contractility markedly in adult rats.…”

Markedly altered colchicine kinetics in a fatal intoxication: Examination of contributing factors

“…Renal extraction is responsible for approximately 20% of colchicine elimination. 3 We report a case of colchicine intoxication, complicated by the presence of co-ingestants, in which serum colchicine concentrations remained quasi-constant over the 3 days of the patient's survival, consistent with marked alterations both in metabolism and excretion. The initial presentation was relatively benign but the subsequent course was one of severe colchicine poisoning, resulting in death.…”