Colchicine Overdose: Journey to recover. Case Report

Colchicine Overdose: Journey to recover. Case Report

Mohamed Ibrahim Shoaib1, Zeyad Faoor Alrais1, Hesham Mohamed ElKholy1, Khalid Omar Hassan1, Marisol Reyes2

1Department of Intensive Care Medicine, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates.
2Mediclinic City Hospital , Dubai, United Arab Emirates.

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Colchicine is an anti-inflammatory alkaloid used for the treatment and prevention of gout, and more recently for the treatment of familial Mediterranean fever (FMF). It has a narrow therapeutic index, with no clear- cut distinction between nontoxic , toxic and lethal doses. Colchicine is rapidly absorbed from the gastrointestinal tract after ingestion, In patients with pre exciting renal and hepatic impairment the possibility of toxicity greatly increases.The clinical course of acute colchicine overdose is divided into three sequential and usually overlapping phases. The first phase is gastrointestinal and the second phase is multi organ failure and death will occur in this phase, the third phase is the recovery stage typically occurs after weeks. We present 38 years old patient who presented to our hospital Accident and Emergency after 8 hours of ingestion of 40 tablets of colchicine. Patient was complaining of nausea and vomiting with repeated watery diarrhea. After 24 hours, Patient was diaphoretic , orthopenic and tachycardic , fluid resuscitation was ongoing , but as patient hemodynamic was unstable requiring vasopressor support patient was shifted to ICU.As the patient had worsening lactic acidosis and acute kidney injury, elective intubation was done and patient was mechanically ventilated. During this stage patient was in multi organ failure (cardiogenic shock, coagulopathy, acute kidney injury, pancytopenia and electrolyte disturbance). After 10 days Patient was tracheostomized due to prolonged intubation , then gradually weaned from mechanically ventilation , pancytopenia resolved with rebound leukocytosis but with delayed in recovery of kidneys so CRRT was continued till renal recovery that was achieved after 3 weeks , Successfully the patient had his tracheostomy tube de-cannulated and discharged after full recovery.

Keywords: Colchicine, over dose, multi organ failure.

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How to cite this article:
Mohamed Ibrahim Shoaib, Zeyad Faoor Alrais, Hesham Mohamed ElKholy, Khalid Omar Hassan, Marisol Reyes.Colchicine Overdose: Journey to recover. Case Report. International Journal of Case Reports, 2018, 2:13. DOI: 10.28933/ijcr-2018-03-2801


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