Evaluation of the Colchicine Poisoning Cases in a Pediatric Intensive Care Unit: Five Year Study

J Emerg Med. 2017 Apr;52(4):499-503. doi: 10.1016/j.jemermed.2016.08.019. Epub 2016 Oct 7.

Abstract

Background: Colchicine poisoning is an uncommon but serious form of drug intoxication. It may produce life-threatening systemic effects. In toxic doses it produces nausea and vomiting and bone marrow suppression, often leading to sepsis, hypocalcemia, adult respiratory distress syndrome, and direct cardiotoxic effects.

Objective: The aim of this study was to describe demographic features and the outcome of patients poisoned with colchicine.

Methods: A retrospective study of the pediatric intensive care unit database was performed for patients ≤18 years of age who had colchicine poisoning between July 2008 and July 2013.

Results: The total number of patients with drug poisoning in the study period was 144. Nine of 144 were related to colchicine poisoning. The median age was 4 years (range 20 months to 16 years) and the number of females was five. Six of the nine cases presented after ingesting <0.5 mg/kg, whereas two patients had consumed 0.5 to 0.8 mg/kg. One patient had received colchicine >0.8 mg/kg. Three patients died.

Conclusions: Among drug intoxications, colchicines can lead to severe clinical conditions. All patients suspected of having colchicine intoxication should be managed in the pediatric intensive care unit regardless of the actual degree of poisoning.

Keywords: child; colchicine; intensive care unit; mortality; poisoning; therapy.

MeSH terms

  • Adolescent
  • Bone Marrow Diseases / etiology
  • Child
  • Child, Preschool
  • Colchicine / pharmacokinetics*
  • Colchicine / poisoning*
  • Colchicum / adverse effects
  • Disseminated Intravascular Coagulation / etiology
  • Drug-Related Side Effects and Adverse Reactions / therapy*
  • Female
  • Humans
  • Hypocalcemia / etiology
  • Infant
  • Intensive Care Units, Pediatric / organization & administration
  • Leukocytosis / complications
  • Leukocytosis / etiology
  • Lymphohistiocytosis, Hemophagocytic / complications
  • Lymphohistiocytosis, Hemophagocytic / etiology
  • Male
  • Nausea / etiology
  • Plasma Exchange / methods
  • Renal Replacement Therapy / methods
  • Respiratory Distress Syndrome / etiology
  • Retrospective Studies
  • Sepsis / etiology
  • Shock / etiology
  • Vomiting / etiology

Substances

  • Colchicine