Colchicine intoxication: a report of two suicide cases
Abdulsamet Erden,1 Hatice Karagoz,1 Hasan Hüseyin Gümüscü,1 Samet Karahan,1 Mustafa Basak,1 Fatma Aykas,1 Kadir Bulut,1 Ali Cetinkaya,1 Deniz Avci,1 Orhan Kürsat Poyrazoglu2 1Internal Medicine Department, 2Gastroenterology Department, Kayseri Training and...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2013-12-01
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| Series: | Therapeutics and Clinical Risk Management |
| Online Access: | http://www.dovepress.com/colchicine-intoxication-a-report-of-two-suicide-cases-a15181 |
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| author | Erden A Karagoz H Gümüscü HH Karahan S Basak M Aykas F Bulut K Cetinkaya A Avci D Poyrazoglu OK |
| author_facet | Erden A Karagoz H Gümüscü HH Karahan S Basak M Aykas F Bulut K Cetinkaya A Avci D Poyrazoglu OK |
| author_sort | Erden A |
| collection | DOAJ |
| description | Abdulsamet Erden,1 Hatice Karagoz,1 Hasan Hüseyin Gümüscü,1 Samet Karahan,1 Mustafa Basak,1 Fatma Aykas,1 Kadir Bulut,1 Ali Cetinkaya,1 Deniz Avci,1 Orhan Kürsat Poyrazoglu2 1Internal Medicine Department, 2Gastroenterology Department, Kayseri Training and Research Hospital, Kayseri, Turkey Abstract: Colchicine, an old and well-known drug, is an alkaloid extracted from Colchicum autumnale and related species. Colchicine inhibits the deposition of uric acid crystals and is an inhibitor of mitosis. Nausea, vomiting, abdominal pain, and diarrhea, with a massive loss of fluid and electrolytes are the first clinical symptoms of colchicine poisoning. Stomach lavage and rapid gastric decontamination with activated charcoal are crucial. An acute dose of about 0.8 mg/kg of colchicine is presumed to be fatal. We report the clinical outcomes of two different cases of colchicine intoxication for attempted suicide. The dose required for morbidity or mortality varies significantly. The dose of 1 mg/kg in the first case was directly related with mortality, while the dose of 0.2 mg/kg in the second was related with survival. The other difference between the patients was the time of arrival to hospital after ingestion. This period was 4 hours for case 1 and only 1, hour for case 2. The initiation of treatment later than 2 hours after ingestion of colchicine may significantly impair treatment because the absorption time for colchicine after oral administration is about 30–120 minutes. The rising lactate level and high anion gap metabolic acidosis in our patient (case 1) were attributed to lactic acidosis, so hemodialysis was performed, and the duration of hemodialysis was prolonged. Lactic acidosis in the first case was one of the reasons for mortality. The most important parameters which define the chance of survival are the dose of ingested drugs and the arrival time to hospital after ingestion. The patients must be monitored closely for lactic acidosis and the decision to start hemodialysis must be made promptly for patients who develop lactic acidosis. Keywords: colchicine intoxication, metabolic acidosis, mortality |
| first_indexed | 2024-12-14T08:42:53Z |
| format | Article |
| id | doaj.art-882990f45ac948a9953609fa4ae164df |
| institution | Directory Open Access Journal |
| issn | 1176-6336 1178-203X |
| language | English |
| last_indexed | 2024-12-14T08:42:53Z |
| publishDate | 2013-12-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Therapeutics and Clinical Risk Management |
| spelling | doaj.art-882990f45ac948a9953609fa4ae164df2022-12-21T23:09:15ZengDove Medical PressTherapeutics and Clinical Risk Management1176-63361178-203X2013-12-012013default505509Colchicine intoxication: a report of two suicide casesErden AKaragoz HGümüscü HHKarahan SBasak MAykas FBulut KCetinkaya AAvci DPoyrazoglu OKAbdulsamet Erden,1 Hatice Karagoz,1 Hasan Hüseyin Gümüscü,1 Samet Karahan,1 Mustafa Basak,1 Fatma Aykas,1 Kadir Bulut,1 Ali Cetinkaya,1 Deniz Avci,1 Orhan Kürsat Poyrazoglu2 1Internal Medicine Department, 2Gastroenterology Department, Kayseri Training and Research Hospital, Kayseri, Turkey Abstract: Colchicine, an old and well-known drug, is an alkaloid extracted from Colchicum autumnale and related species. Colchicine inhibits the deposition of uric acid crystals and is an inhibitor of mitosis. Nausea, vomiting, abdominal pain, and diarrhea, with a massive loss of fluid and electrolytes are the first clinical symptoms of colchicine poisoning. Stomach lavage and rapid gastric decontamination with activated charcoal are crucial. An acute dose of about 0.8 mg/kg of colchicine is presumed to be fatal. We report the clinical outcomes of two different cases of colchicine intoxication for attempted suicide. The dose required for morbidity or mortality varies significantly. The dose of 1 mg/kg in the first case was directly related with mortality, while the dose of 0.2 mg/kg in the second was related with survival. The other difference between the patients was the time of arrival to hospital after ingestion. This period was 4 hours for case 1 and only 1, hour for case 2. The initiation of treatment later than 2 hours after ingestion of colchicine may significantly impair treatment because the absorption time for colchicine after oral administration is about 30–120 minutes. The rising lactate level and high anion gap metabolic acidosis in our patient (case 1) were attributed to lactic acidosis, so hemodialysis was performed, and the duration of hemodialysis was prolonged. Lactic acidosis in the first case was one of the reasons for mortality. The most important parameters which define the chance of survival are the dose of ingested drugs and the arrival time to hospital after ingestion. The patients must be monitored closely for lactic acidosis and the decision to start hemodialysis must be made promptly for patients who develop lactic acidosis. Keywords: colchicine intoxication, metabolic acidosis, mortalityhttp://www.dovepress.com/colchicine-intoxication-a-report-of-two-suicide-cases-a15181 |
| spellingShingle | Erden A Karagoz H Gümüscü HH Karahan S Basak M Aykas F Bulut K Cetinkaya A Avci D Poyrazoglu OK Colchicine intoxication: a report of two suicide cases Therapeutics and Clinical Risk Management |
| title | Colchicine intoxication: a report of two suicide cases |
| title_full | Colchicine intoxication: a report of two suicide cases |
| title_fullStr | Colchicine intoxication: a report of two suicide cases |
| title_full_unstemmed | Colchicine intoxication: a report of two suicide cases |
| title_short | Colchicine intoxication: a report of two suicide cases |
| title_sort | colchicine intoxication a report of two suicide cases |
| url | http://www.dovepress.com/colchicine-intoxication-a-report-of-two-suicide-cases-a15181 |
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