Colchicine intoxication: a report of two suicide cases
A 17-year-old, 47 kg female patient with a diagnosis of FMF was admitted to a local hospital with the complaints of nausea and vomiting after taking 9.5 mg or 0.2 mg/kg (19 tablets of 0.5 mg) colchicine for suicide attempt. She underwent stomach lavage and treatment with activated charcoal at that facility, and was transferred to our hospital an hour after ingestion. She was conscious, responsive, and cooperative, and she had diarrhea. On physical examination she had a blood pressure of 125/55 mmHg, body temperature 36.5°C, respiratory rate 15 breaths/minute, and heart rate 70 beats/minute. The patient was pale and cold, and she had abdominal tenderness on palpation. Other system examinations were unremarkable. She was admitted to the intensive care unit. Her initial laboratory findings in the intensive care unit were WBC, 6.640 (103 μL); hemoglobin, 13 gr/dL; hematocrit, 40.3%; PLTs, 428,000/mm3; AST, 32 U/L; ALT, 21 U/L; sodium, 139 mmol/L; K, 4.1 mmol/L; Ca, 9.5 mmol/L; Total-CK, 112 U/L; CK-MB, 25 U/L; LDH, 156 U/L; troponin I, 0.00 ng/ml; D-dimer, 1,833.78 ng/L; INR, 1.14; BUN, 13 mg/dL; Cr, 0.7 mg/dL. Blood gas values were: pH, 7.48; pCO2, 21.2 mmHg; HCO3, 20.0 mmol/L; BE, −5.9 mmol/L. Following the recommendation of the contacted poison control center, gastric lavage was performed again and activated charcoal was given every hour for 6 hours (0.25 g/kg per hour) to reduce the intestinal colchicine absorption. Blood gas analyses were performed every 12 hours (). On follow-up of the patient, AST, ALT, Total-CK, CK-MB, troponin I, LDH, and INR remained normal (). Normal sinus rhythm was determined by electrocardiography, and echocardiography revealed the left ventricle had normal systolic function and an ejection fraction of 60%. She did not need hemodialysis and was transferred to the internal medicine service on the fifth day of her admission. The consultant psychiatrist diagnosed a depressive episode as the underlying cause for her suicide attempt. She recovered without sequelae and was discharged on the seventh day of her follow-up.