Severe Colchicine Intoxication: A Case Report and Review of Literature in Adults

Seixas, Rui; Lopes, Diogo; Couto, Marta; Pereira, José Renato; Paiva, J. I. C.

doi:10.7759/cureus.19151

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…In contrast, massive colchicine overdoses i.e. 1.125 mg/kg [ 18 ] or 1.38 mg/kg [ 19 ] have been reported to lead to recovery. These levels are clearly higher than the fatal ones.…”

Section: Discussionmentioning

confidence: 99%

Effect of an Accidental Colchicine Overdose in a COVID-19 Inpatient With Bilateral Pneumonia and Pericardial Effusion

Mondeshki¹,

Bilyukov²,

Mitev³

2023

Cureus

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A 32-year-old patient with COVID-19 pneumonia and pericardial effusion mistakenly took 15 mg of colchicine over 10 hours. He developed diarrhea that resolved two days after colchicine was stopped. Remarkably, this single overdose of colchicine, without any additional therapy, resulted in the complete recovery of bilateral pneumonia and pericardial effusion, and the patient was discharged on the hospital day 9th. This case demonstrates the possibility that high colchicine doses may have a major role and a dramatic effect in the treatment of COVID-19 patients.

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“…In contrast, massive colchicine overdoses i.e. 1.125 mg/kg [ 18 ] or 1.38 mg/kg [ 19 ] have been reported to lead to recovery. These levels are clearly higher than the fatal ones.…”

Section: Discussionmentioning

confidence: 99%

Effect of an Accidental Colchicine Overdose in a COVID-19 Inpatient With Bilateral Pneumonia and Pericardial Effusion

Mondeshki¹,

Bilyukov²,

Mitev³

2023

Cureus

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“…Second, multiorgan failure phase, including respiratory, cardiac, renal, hepatic, and bone marrow failure and metabolic derangements. Severe form of colchicine toxicity with multiple organ failure may contribute to potentially fatal outcome 36–38. This phase typically occurs at 1–7 days after the onset of toxicity.…”

Section: Discussionmentioning

confidence: 99%

CYP3A4/P-glycoprotein inhibitors related colchicine toxicity mimicking septic shock

Ngeyvijit,

Nuansuwan,

Phoophiboon

2023

BMJ Case Rep

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Colchicine toxicity is uncommon when patients receive a therapeutic dose regularly. However, inadvertent drug interactions can result in unpredicted adverse outcomes. The toxicity of colchicine can manifest in various ways, ranging from mild and non-specific symptoms to severe form known as multiple organ dysfunction syndrome. This case highlights (1) the diagnostic challenge that arises when distinguishing between the severe manifestation of colchicine toxicity and septic shock and (2) concomitant prescription of colchicine with potent CYP3A4 and P-glycoprotein inhibitors (ie, clarithromycin) can lead to colchicine toxicity despite normal renal and hepatic clearance. Unfortunately, specific tests of colchicine toxicity were not routinely available. A high index of clinical suspicion and recognition of drug interactions with their common presentations are crucial for making diagnosis and management. Failure to recognise drug toxicity can result in poor outcomes.

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“…It would contribute to a delay in medical treatment. Therefore, antimicrobial agents are selected empirically at the right time based on the clinical manifestations and inflammatory biomarkers [e.g., C-reactive protein (CRP) and procalcitonin] in the absence of positive cultures [ 20 , 52 ]. Particularly, it should also be noted that inappropriate antibiotics might select microbial/fungal resistance.…”

Section: Antimicrobial Therapymentioning

confidence: 99%

“…Severe colchicine poisoning can lead to myelosuppression followed by leukopenia and immune dysfunction with an increased risk of infection. Many previous studies illustrated that patients with colchicine intoxication were susceptible to infections due to the change in granulocyte counts and inhibition of leukocyte functions [50][51][52]. Antimicrobial therapy is essential for patients with colchicine poisoning at an appropriate time.…”

Section: Antimicrobial Therapymentioning

confidence: 99%

Progress in the management of acute colchicine poisoning in adults

Liu

2022

Intern Emerg Med

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Colchicine is a tricyclic, lipid-soluble alkaloid which has long been used to treat gout and many immunological diseases. Due to its narrow therapeutic window and long half-life of elimination, colchicine overdose occurs occasionally. Unfortunately, some patients lost their lives because of colchicine overdose or suicide. Acute colchicine poisoning can lead to original gastrointestinal disorders, shock, progressive multiple organ failure, and myelosuppression. Although many researchers in the world performed lots of research, there are currently no specific antidotes for colchicine poisoning. Meanwhile, there are no management guidelines to treat patients with acute colchicine poisoning until now. Herein, we systematically elaborate on the clinical features and progress in the management of acute colchicine poisoning in adults according to the previous literature. This paper will provide some valuable and available information for clinicians.

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Severe Colchicine Intoxication: A Case Report and Review of Literature in Adults

Cited by 5 publications

References 16 publications

Effect of an Accidental Colchicine Overdose in a COVID-19 Inpatient With Bilateral Pneumonia and Pericardial Effusion

Effect of an Accidental Colchicine Overdose in a COVID-19 Inpatient With Bilateral Pneumonia and Pericardial Effusion

CYP3A4/P-glycoprotein inhibitors related colchicine toxicity mimicking septic shock

Progress in the management of acute colchicine poisoning in adults

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