title: Severe colchicine intoxication in a renal transplant recipient on cyclosporine.
abstract: Using colchicine to treat an acute gout crisis in an organ transplant recipient (TR) on cyclosporine (CsA) may result in life-threatening intoxication. We report the case of a 59-year-old kidney transplant recipient on CsA who was treated with colchicine for acute gout crisis. Seven days later, he developed rhabdomyolysis with progressive quadriparesis, hematologic toxicity and acute renal failure. CsA inhibits P-glycoprotein resulting in decreased hepatic metabolism and renal excretion of colchicine. Colchicine and CsA withdrawal as well as appropriate supportive treatments were effective to manage all of these complications.
authors.affiliation: Department of Nephrology, Dialysis and Renal Transplantation, University Hospital, Clermont-Ferrand, France. cgarrouste@chu-clermontferrand.fr
authors.forename: C
authors.initials: C
authors.lastname: Garrouste
authors.forename: C
authors.initials: C
authors.lastname: Philipponnet
authors.forename: S
authors.initials: S
authors.lastname: Kaysi
authors.forename: I
authors.initials: I
authors.lastname: Enache
authors.forename: A
authors.initials: A
authors.lastname: Tiple
authors.forename: A E
authors.initials: AE
authors.lastname: Heng
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000628:therapy; D000069059:Atorvastatin; D003078:Colchicine / Q000009:adverse effects* / Q000378:metabolism; D016572:Cyclosporine / Q000009:adverse effects*; D004347:Drug Interactions; D006073:Gout / Q000188:drug therapy* / Q000209:etiology; D006074:Gout Suppressants / Q000009:adverse effects* / Q000378:metabolism; D006538:Heptanoic Acids / Q000009:adverse effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000009:adverse effects; D011782:Quadriplegia / Q000139:chemically induced / Q000628:therapy; D012206:Rhabdomyolysis / Q000139:chemically induced / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D006074:Gout Suppressants; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007166:Immunosuppressive Agents; D011758:Pyrroles; D016572:Cyclosporine; D000069059:Atorvastatin; D003078:Colchicine