Colchicine overdose
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Various toxicities following suicide attempt: case report A 21-year-old woman developed pancytopenia, respiratory disorders, oral and nasal mucosal bleeding, metabolic acidosis, loss of consciousness, hepatic encephalopathy, abdominal distension and ascites, neuromyopathy, tachycardia and polyuria following a suicide attempt by colchicine overdose. The woman was hospitalised after she attempted suicide by ingesting 30 tablets of her mother’s prescribed colchicine (estimated dose 30mg). She complained of weakness, vomiting, severe chest pain, abdominal pain, lethargy and agitation. Hence, she was admitted to the cardiac care unit due to a lack of ICU beds. Upon admission, she was conscious and able to speak. Her Glasgow coma scale score was 13. Her vital signs were as follows: BP 120/75mm Hg, pulse rate 71 /minute in sinus rhythm, body temperature 37.1°C, RR 14, O2 saturation 27% and 56% (before and after oxygen therapy, respectively). The next day after admission, her laboratory test results revealed colchicine-induced pancytopenia with thrombocytopenia and neutropenia. She also developed nasal and oral mucosal bleeding, nausea, vomiting, elevated body temperature and metabolic acidosis. The woman received treatment with tranexamic acid, vitamin K, epinephrine, fresh frozen plasma, ranitidine, sodium bicarbonate, ondansetron, acetylcysteine and bromhexine. On hospital day 3, she lost consciousness. She also developed hepatic encephalopathy and was transferred to the ICU. At the time of ICU admission, her vital signs were as follows: BP 120/70mm Hg, pulse rate 110 /minute, RR 18 and body temperature 37.3°C. Further, she developed acute respiratory distress syndrome associated with respiratory insufficiency and aspiration pneumonia. She was intubated and received treatment with antibacterials. On hospital day 5, her clinical examination was consistent with hypocalcaemia and hypophosphataemia, which was treated with calcium gluconate, calcitriol and sodium phosphate. A clinical examination was consistent with abdominal distension and ascites. A CT scan showed inflamed spleen, liver and mesenteric arteries. She was also found to have polyuria, neuromyopathy and tachycardia, which were treated accordingly. On hospital day 10, her clinical condition started to normalise, hence, she was transferred to the internal ward. At the time of discharge, after 17 days of hospitalisation, she was in a stable clinical condition, except her tachycardia. She was scheduled for follow-up appointments. Eghbali F, et al. Case report: Colchicine overdose in a suicidal attempt. International Journal of Medical Toxicology and Forensic Medicine 9: 265-270, No. 4, 2019. Available 803448707 from: URL: http://doi.org/10.32598/ijmtfm.v9i4.26520
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Reactions 25 Jan 2020 No. 1788
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