Abstract
1. Colchicine poisoning, which is relatively rare, is associated with significant morbidity and mortality. Whilst a new treatment modality, in the form of colchicine-specific Fab fragments is on the horizon, currently available therapy is largely supportive. 2. The elimination of colchicine occurs primarily by hepatic metabolism, following a first-order process, with significant enterohepatic circulation. Renal extraction is responsible for approximately 20% of colchicine elimination. 3. We report a case of colchicine intoxication, complicated by the presence of co-ingestants, in which serum colchicine concentrations remained quasi-constant over the 3 days of the patient's survival, consistent with marked alterations both in metabolism and excretion. The initial presentation was relatively benign but the subsequent course was one of severe colchicine poisoning, resulting in death. 4. Severe colchicine toxicity appears to have resulted in a vicious cycle of progressive organ dysfunction and impaired elimination. 5. Josamycin, one of the co-ingestants and an inhibitor of P-glycoprotein, the membrane pump responsible for multidrug resistance, may have played a significant role in impeding the cellular and biliary elimination of co...Continue Reading
References
Jan 1, 1979·Clinical Toxicology
Oct 1, 1977·Proceedings of the National Academy of Sciences of the United States of America·R McMackenA Kornberg
Apr 1, 1979·Clinical Toxicology·D JarvieM J Stewart
Jul 16, 1976·Science·N H ErtelS L Wallace
Nov 1, 1992·Human & Experimental Toxicology·M RochdiJ M Scherrmann
May 1, 1992·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·K V SpeegD Muirhead
Jan 1, 1991·Toxicology·A SabouraudJ M Scherrmann
May 1, 1991·Journal of Analytical Toxicology·C V ClevengerL M Shaw
Oct 1, 1991·Toxicology Letters·M UrtizbereaJ M Scherrmann
Jul 1, 1990·Toxicology and Applied Pharmacology·N TerrienJ M Scherrmann
Jan 1, 1989·Fundamental & Clinical Pharmacology·C GirreP E Fournier
Jun 1, 1989·Toxicology·J M ScherrmannN Terrien
Dec 4, 1986·The New England Journal of Medicine·M M KaplanK A Eagen
Oct 1, 1973·Proceedings of the National Academy of Sciences of the United States of America
Oct 31, 1974·The New England Journal of Medicine·D ZemerJ Gafni
May 1, 1973·Metabolism: Clinical and Experimental·S L Wallace, N H Ertel
Jun 1, 1971·Human Pathology·G N Stemmermann, T Hayashi
Apr 1, 1970·The American Journal of Medicine·S L WallaceN H Ertel
Feb 1, 1971·Postgraduate Medical Journal·M G Ellwood, G H Robb
Apr 23, 1966·British Medical Journal·B W Gooneratne
Nov 1, 1980·The Journal of Pharmacy and Pharmacology·J M ScherrmannE Fournier
May 1, 1983·Biochemical Pharmacology·D LarreyD Pessayre
Jul 1, 1981·Annals of Emergency Medicine·J S StapczynskiJ T Niemann
May 1, 1980·Journal of Analytical Toxicology·Y H CaplanB C Thompson
Mar 9, 1995·The New England Journal of Medicine·F J BaudJ M Scherrmann
Jan 1, 1994·European Journal of Clinical Pharmacology·M RochdiJ M Scherrmann
Apr 1, 1994·Scandinavian Journal of Gastroenterology·J RudiB Kommerell
Jan 1, 1995·La Revue de médecine interne·O Chappey, J M Scherrmann
Jan 1, 1965·Archives of Internal Medicine·A A CARR
Citations
Apr 20, 2004·Wiener klinische Wochenschrift·Miran BrvarMatjaz Bunc
Jul 12, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·I F N HungK Y Yuen
Feb 23, 2007·International Journal of Clinical Practice·A A TahraniP Moulik
Oct 16, 2009·Cases Journal·Bernhard ZaglerChristian J Wiedermann
Feb 21, 2004·Critical Care : the Official Journal of the Critical Care Forum·Miran BrvarMatjaz Bunc
Jan 1, 2014·Medicina clínica·Sara FernándezJosep María Nicolás
Dec 4, 2013·Bioanalysis·Emmanuel BourgogneOlivier Laprévote
Apr 16, 2004·Journal of Toxicology. Clinical Toxicology·Lucija GabrscekBoris Jagodic
Oct 26, 2010·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Virginie MontielPhilippe Hantson
Jul 1, 2010·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Yaron FinkelsteinYedidia Bentur
Jul 9, 2008·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Giorgio EleftheriouRoberta Sebastiano
Sep 14, 2011·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Ramazan OzdemirOzlem Teksam
Apr 11, 2015·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Philip W PeakeZoltan H Endre
Nov 1, 2008·Seminars in Arthritis and Rheumatism·Robert A Terkeltaub
Mar 8, 2005·Forensic Science International : Synergy·Zeljko SundovAnte Tonkic
Jul 9, 2004·Forensic Science International : Synergy·Marc DeveauxChristophe Demarly
Dec 6, 2018·Biological Chemistry·Mikhail BarkovskiyArne Skerra
Oct 21, 1998·Therapeutic Drug Monitoring·M J StewartM Zuckerman
May 24, 2014·CJEM·Anjuli LittleLisa Burry
Mar 20, 2019·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Thilini Madushanka WijerathnaNicholas Alan Buckley
Jul 28, 2001·The American Journal of Surgical Pathology·C A Iacobuzio-DonahueT T Wu
Oct 21, 2004·The Annals of Pharmacotherapy·Florence RollotPhilippe Blanche
Sep 4, 2015·Pediatric Emergency Care·Göksel VatanseverTanl Kendirli
Jul 28, 2019·Medicine·Mingjie FuAnwei Lu
Aug 25, 2020·Current Pharmacology Reports·Naomi SchlesingerLuigi Brunetti
Jan 20, 2021·Heart, Lung & Circulation·Rahul KurupSanjay Patel
Apr 27, 2021·Frontiers in Pediatrics·Maria Pérez MarínDavid Longchamp
Nov 7, 2020·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Gasper RazingerMiran Brvar
Apr 18, 2002·Archives of Pathology & Laboratory Medicine·Michael TorbensonSusan C Abraham
Aug 21, 2021·The American Journal of Medicine·Philip C RobinsonMark Nidorf