Fatal cardiovascular collapse following acute colchicine ingestion.
BACKGROUND
A previously published prognostic rule predicts 100% survival after ingestion of cochicine doses less than 0.5 mg/kg and 100% mortality after ingestion of more than 0.8 mg/kg. This rule inaccurately predicted survival in a recent case.


METHODS
We present a case of fatal colchicine poisoning in an adult who ingested a maximum of 39.6 mg of colchicine (0.40 mg/kg). He subsequently developed hypotension which was refractory to fluid resuscitation and infusion of vasopressors. He died of cardiovascular collapse approximately 35 hours after ingestion.


CONCLUSIONS
Fatal outcomes are possible even with colchicine doses less than 0.5 mg/kg. Physicians caring for colchicine-poisoned patients must be prepared for the possibility of acute cardiovascular collapse and ventricular dysrhythmias regardless of the reported dose of colchicine.
Mullins
M E
ME
Oregon Poison Center, Oregon Health Sciences University, Portland, USA. mmullins@im.wustl.edu
Carrico
E A
EA
Horowitz
B Z
BZ
D000328:Adult; D003078:Colchicine / Q000506:poisoning*; D017809:Fatal Outcome; D005440:Fluid Therapy; D006074:Gout Suppressants / Q000506:poisoning*; D006801:Humans; D007022:Hypotension / Q000139:chemically induced / Q000188:drug therapy / Q000628:therapy; D008297:Male; D011379:Prognosis; D012151:Resuscitation / Q000379:methods; D012769:Shock / Q000139:chemically induced* / Q000188:drug therapy / Q000628:therapy; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D006074:Gout Suppressants; D014662:Vasoconstrictor Agents; D003078:Colchicine