Original Article

Colchicine Exposures: The Texas Experience

Authors: Marc E. Levsky, MD, Michael A. Miller, MD, David A. Masneri, DO, Doug Borys, PharmD

Abstract

Objectives: Colchicine is a relatively uncommon toxin, but is known to precipitate severe multiorgan failure in overdose. Little is known about exposure patterns and outcomes in cases of colchicine ingestion. Our goal was to add to toxicologic knowledge through a database review and descriptive study of colchicine exposures.


Methods: Texas Poison Center Network Data was reviewed for the years 2000 to 2005, and all reports of colchicine exposures were reviewed.


Results: A total of 79 cases were found in the time period studied. The most common exposure reasons were unintentional-therapeutic error (33%), unintentional-general (28%), and intentional-suspected suicide (18%). Medical outcomes included no effect (24%), minor effect (20%), moderate effect (15%), and major effect (3%). The most common clinical findings included vomiting (20%), diarrhea (17%), and abdominal pain (7%). The most commonly employed therapies were dilution (28%), single-dose activated charcoal (26%), cathartics (16%), and gastrointestinal lavage (15%).


Conclusion: The majority of cases of exposure produced no significant effects, and fatality was uncommon in this sample. Colchicine is a relatively uncommon toxin among therapeutic drugs, and though capable of it, is rarely responsible for significant morbidity or mortality. Meticulous exposure record keeping at poison centers is a key to the study of patterns of toxicity with uncommon toxins such as colchicine.


Key Points


* Colchicine is a commonly used drug, but a relatively uncommon cause of poisoning.


* Although colchicine may be lethal in overdose, most cases of ingestion produce no adverse effects, and patients recover without specific treatment.


* Most common reasons for poisoning were therapeutic error, ingestion by children, and attempted suicide.

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