Possible Colchicine Poisoning: Case Study

Abstract

We have experienced a case of colchicine toxicity presenting with rapidly progressive gastrointestinal symptoms, hemodynamic instability, and multiple organ failure.
 An 86-year-old Japanese man presented to our hospital with subarachnoidal hemorrhage transferring from another hospital where he had been treated with colchicine 0.5 mg three times daily for an elevated uric acid level. During his admission, he had a nosocomial COVID-19 infection. Then, he developed loss of appetite, and significant diarrhea, which continued for two days. He then developed shock and hypoxia and was transferred to intensive care unit (ICU). The laboratory data revealed pancytopenia, acute kidney injury, lactic acidosis, marked coagulopathy, elevated troponin I, and C-reactive protein with poor cardiac function and hypotension refractory to vasopressors. Despite intensive care, he expired on 2nd day of ICU admission. Because his cardiac function was depressed from the beginning and was not respond to inotropic support, direct myocardial damage, rather than septic cardiomyopathy was suspected. We, therefore, emphasize that colchicine poisoning should be suspected in patients with access to the drug and the typical toxidrome.