Case Report: Colchicine Toxicokinetic Analysis in a Poisoned Child Requiring Extracorporeal Life Support
Colchicine poisoning is associated with a poor prognosis, especially when leading to shock and multi-organ failure, and management is limited to supportive care, including multiple-dose activated charcoal. At therapeutic concentrations, colchicine elimination occurs mainly through hepatic metabolism...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-04-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2021.658347/full |
| _version_ | 1818863566596341760 |
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| author | Maria Pérez Marín Sylvain Prod'hom Suzanne Francesca de Villiers Thomas Ferry Vivianne Amiet Julia Natterer Maria-Helena Perez Thierry Buclin Haithem Chtioui David Longchamp |
| author_facet | Maria Pérez Marín Sylvain Prod'hom Suzanne Francesca de Villiers Thomas Ferry Vivianne Amiet Julia Natterer Maria-Helena Perez Thierry Buclin Haithem Chtioui David Longchamp |
| author_sort | Maria Pérez Marín |
| collection | DOAJ |
| description | Colchicine poisoning is associated with a poor prognosis, especially when leading to shock and multi-organ failure, and management is limited to supportive care, including multiple-dose activated charcoal. At therapeutic concentrations, colchicine elimination occurs mainly through hepatic metabolism and involves an enterohepatic circulation, with a small contribution of renal elimination (10–30%). Colchicine toxicokinetics is however rarely described, especially in children. We present the case of a 4-year-old patient who survived a severe iatrogenic colchicine intoxication with a dose of 0.5 mg/kg. She developed multi-organ failure and shock, but recovered after receiving aggressive resuscitation, including extracorporeal life support. Close monitoring of colchicine blood levels showed a plateau for 6 days, indicating impeded elimination resulting from liver failure. We observed no significant clearance from renal replacement therapy, nor activated charcoal, during this period. Extracorporeal life support may play a supportive role in the management of severe colchicine poisoning. However, extracorporeal techniques do not seem to improve colchicine elimination. |
| first_indexed | 2024-12-19T10:17:48Z |
| format | Article |
| id | doaj.art-fc5feaa12d49431b987258fd7e486989 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-19T10:17:48Z |
| publishDate | 2021-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-fc5feaa12d49431b987258fd7e4869892022-12-21T20:26:11ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602021-04-01910.3389/fped.2021.658347658347Case Report: Colchicine Toxicokinetic Analysis in a Poisoned Child Requiring Extracorporeal Life SupportMaria Pérez Marín0Sylvain Prod'hom1Suzanne Francesca de Villiers2Thomas Ferry3Vivianne Amiet4Julia Natterer5Maria-Helena Perez6Thierry Buclin7Haithem Chtioui8David Longchamp9Pediatric Intensive Care Unit, Lausanne University Hospital and University of Lausanne, Lausanne, SwitzerlandService of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Lausanne, SwitzerlandPediatric Intensive Care Unit, Lausanne University Hospital and University of Lausanne, Lausanne, SwitzerlandPediatric Intensive Care Unit, Lausanne University Hospital and University of Lausanne, Lausanne, SwitzerlandPediatric Intensive Care Unit, Lausanne University Hospital and University of Lausanne, Lausanne, SwitzerlandPediatric Intensive Care Unit, Lausanne University Hospital and University of Lausanne, Lausanne, SwitzerlandPediatric Intensive Care Unit, Lausanne University Hospital and University of Lausanne, Lausanne, SwitzerlandService of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Lausanne, SwitzerlandService of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Lausanne, SwitzerlandPediatric Intensive Care Unit, Lausanne University Hospital and University of Lausanne, Lausanne, SwitzerlandColchicine poisoning is associated with a poor prognosis, especially when leading to shock and multi-organ failure, and management is limited to supportive care, including multiple-dose activated charcoal. At therapeutic concentrations, colchicine elimination occurs mainly through hepatic metabolism and involves an enterohepatic circulation, with a small contribution of renal elimination (10–30%). Colchicine toxicokinetics is however rarely described, especially in children. We present the case of a 4-year-old patient who survived a severe iatrogenic colchicine intoxication with a dose of 0.5 mg/kg. She developed multi-organ failure and shock, but recovered after receiving aggressive resuscitation, including extracorporeal life support. Close monitoring of colchicine blood levels showed a plateau for 6 days, indicating impeded elimination resulting from liver failure. We observed no significant clearance from renal replacement therapy, nor activated charcoal, during this period. Extracorporeal life support may play a supportive role in the management of severe colchicine poisoning. However, extracorporeal techniques do not seem to improve colchicine elimination.https://www.frontiersin.org/articles/10.3389/fped.2021.658347/fullcolchicine poisoningECMOtoxicokineticspediatriccase report |
| spellingShingle | Maria Pérez Marín Sylvain Prod'hom Suzanne Francesca de Villiers Thomas Ferry Vivianne Amiet Julia Natterer Maria-Helena Perez Thierry Buclin Haithem Chtioui David Longchamp Case Report: Colchicine Toxicokinetic Analysis in a Poisoned Child Requiring Extracorporeal Life Support Frontiers in Pediatrics colchicine poisoning ECMO toxicokinetics pediatric case report |
| title | Case Report: Colchicine Toxicokinetic Analysis in a Poisoned Child Requiring Extracorporeal Life Support |
| title_full | Case Report: Colchicine Toxicokinetic Analysis in a Poisoned Child Requiring Extracorporeal Life Support |
| title_fullStr | Case Report: Colchicine Toxicokinetic Analysis in a Poisoned Child Requiring Extracorporeal Life Support |
| title_full_unstemmed | Case Report: Colchicine Toxicokinetic Analysis in a Poisoned Child Requiring Extracorporeal Life Support |
| title_short | Case Report: Colchicine Toxicokinetic Analysis in a Poisoned Child Requiring Extracorporeal Life Support |
| title_sort | case report colchicine toxicokinetic analysis in a poisoned child requiring extracorporeal life support |
| topic | colchicine poisoning ECMO toxicokinetics pediatric case report |
| url | https://www.frontiersin.org/articles/10.3389/fped.2021.658347/full |
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