Severe hypertriglyceridemia and colchicine intoxication following suicide attempt

Abstract

Colchicine overdose is uncommon but potentially life threatening. Due to its serious adverse systemic effects, overdose must be recognized and treated. We report a case of an 18-year-old female who ingested 18 mg (~0.4 mg/kg) of colchicine in a suicide attempt. The patient’s clinical manifestations included abdominal cramps, vomiting, pancytopenia, hypocholesterolemia, and rhabdomyolysis. Two unique manifestations of toxicity in this patient were profound and persistent, severe hypertriglyceridemia and electrolyte imbalance, mainly hypophosphatemia, with no other evident cause except the colchicine intoxication. Following intensive supportive treatment, including ventilator support, N-acetylcysteine, granulocyte colony stimulating factor, electrolyte repletion, and zinc supplementation, the patient made a complete recovery. Colchicine intoxication is a severe, life-threatening situation that should be followed closely in intensive care units. Severe changes in body functions can rapidly develop, as previously described in the literature. To our knowledge, this extremely elevated triglyceride level has never been reported without the administration of propofol, and requires further evaluation.

Colchicine Overdose in a Suicidal Attempt

“…If the patient survives the second phase, transient alopecia and a rebound leukocytosis may occur in the third phase. Neuromyopathy, cytopenias (especially thrombocytopenia), and elevated Creatine Phosphokinase (CPK) level are classic features associated with chronic colchicine toxicity [1,2,[11][12][13][14][15].…”

“…The anti-inflammatory effects of colchicine are preventing activation, degranulation, and the migration of C neutrophils. In addition, colchicine inhibits the deposition of uric acid crystals and mitosis [1][2][3].…”

Progress in the management of acute colchicine poisoning in adults

“…It is well known that colchicine can induce endothelial and mucosal damage due to oxidative stress [ 53 ]. N -Acetylcysteine (NAC) exhibits its antioxidant ability by reducing oxidant-induced cell damage and apoptosis [ 54 ].…”

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

“…Female Most of the reported cases of colchicine intoxication are due to intent to self-harm [11][12][13][14], either by ingestion of colchicine-rich plants or several colchicine tablets. However, there are many other causes for colchicine intoxication such as accidental ingestion of colchicine-enriched plants or colchicine interaction with other drugs.…”