Severe colchicine poisoning treated successfully with kidney replacement therapy and plasmapheresis: a case report
AbstractColchicine is commonly prescribed for treatment of inflammatory conditions but has a narrow therapeutic window and dangerous toxicity profile. Here we describe a case of survival after massive unintentional colchicine overdose treated with plasmapheresis and renal replacement therapy. A 37 y...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2022-12-01
|
| Series: | Toxicology Communications |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/24734306.2022.2055817 |
| _version_ | 1797805396051623936 |
|---|---|
| author | D. H. Schaffer D. L. Overbeek T. B. Erickson E. W. Boyer C. Goldfine S. A. Muhsin P. R. Chai |
| author_facet | D. H. Schaffer D. L. Overbeek T. B. Erickson E. W. Boyer C. Goldfine S. A. Muhsin P. R. Chai |
| author_sort | D. H. Schaffer |
| collection | DOAJ |
| description | AbstractColchicine is commonly prescribed for treatment of inflammatory conditions but has a narrow therapeutic window and dangerous toxicity profile. Here we describe a case of survival after massive unintentional colchicine overdose treated with plasmapheresis and renal replacement therapy. A 37 year old male with history of pericarditis presented to the Emergency Department with a chief complaint of nausea, vomiting, and diarrhea after unintentionally ingesting 36 mg of colchicine 17 h prior to arrival. An initial colchicine concentration resulted at 5.1 ng/mL (30 h post-ingestion) and peaked at 12 ng/mL (40 h post-ingestion). He was treated with continuous kidney replacement therapy (CKRT) beginning on his first day of hospitalization and with plasmapheresis on hospital days two through four. The patient’s course was complicated by multiorgan failure including coagulopathy, respiratory failure, neuropathy, renal failure, pancytopenia, and heart failure. He was discharged to inpatient rehabilitation on hospital day 24. On clinical follow up four months after discharge the patient was found to have no significant persistent morbidity related to colchicine overdose. |
| first_indexed | 2024-03-13T05:51:26Z |
| format | Article |
| id | doaj.art-fd1e400f19bb4862b857f3756e05717c |
| institution | Directory Open Access Journal |
| issn | 2473-4306 |
| language | English |
| last_indexed | 2024-03-13T05:51:26Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Toxicology Communications |
| spelling | doaj.art-fd1e400f19bb4862b857f3756e05717c2023-06-13T12:55:24ZengTaylor & Francis GroupToxicology Communications2473-43062022-12-0161465010.1080/24734306.2022.2055817Severe colchicine poisoning treated successfully with kidney replacement therapy and plasmapheresis: a case reportD. H. Schaffer0D. L. Overbeek1T. B. Erickson2E. W. Boyer3C. Goldfine4S. A. Muhsin5P. R. Chai6Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, USADepartment of Emergency Medicine, University of Rochester Medical Center, Rochester, NY, USADepartment of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, USADepartment of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USADepartment of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, USARenal Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USADepartment of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, USAAbstractColchicine is commonly prescribed for treatment of inflammatory conditions but has a narrow therapeutic window and dangerous toxicity profile. Here we describe a case of survival after massive unintentional colchicine overdose treated with plasmapheresis and renal replacement therapy. A 37 year old male with history of pericarditis presented to the Emergency Department with a chief complaint of nausea, vomiting, and diarrhea after unintentionally ingesting 36 mg of colchicine 17 h prior to arrival. An initial colchicine concentration resulted at 5.1 ng/mL (30 h post-ingestion) and peaked at 12 ng/mL (40 h post-ingestion). He was treated with continuous kidney replacement therapy (CKRT) beginning on his first day of hospitalization and with plasmapheresis on hospital days two through four. The patient’s course was complicated by multiorgan failure including coagulopathy, respiratory failure, neuropathy, renal failure, pancytopenia, and heart failure. He was discharged to inpatient rehabilitation on hospital day 24. On clinical follow up four months after discharge the patient was found to have no significant persistent morbidity related to colchicine overdose.https://www.tandfonline.com/doi/10.1080/24734306.2022.2055817Colchicineoverdoseplasmapharesiscase report |
| spellingShingle | D. H. Schaffer D. L. Overbeek T. B. Erickson E. W. Boyer C. Goldfine S. A. Muhsin P. R. Chai Severe colchicine poisoning treated successfully with kidney replacement therapy and plasmapheresis: a case report Toxicology Communications Colchicine overdose plasmapharesis case report |
| title | Severe colchicine poisoning treated successfully with kidney replacement therapy and plasmapheresis: a case report |
| title_full | Severe colchicine poisoning treated successfully with kidney replacement therapy and plasmapheresis: a case report |
| title_fullStr | Severe colchicine poisoning treated successfully with kidney replacement therapy and plasmapheresis: a case report |
| title_full_unstemmed | Severe colchicine poisoning treated successfully with kidney replacement therapy and plasmapheresis: a case report |
| title_short | Severe colchicine poisoning treated successfully with kidney replacement therapy and plasmapheresis: a case report |
| title_sort | severe colchicine poisoning treated successfully with kidney replacement therapy and plasmapheresis a case report |
| topic | Colchicine overdose plasmapharesis case report |
| url | https://www.tandfonline.com/doi/10.1080/24734306.2022.2055817 |
| work_keys_str_mv | AT dhschaffer severecolchicinepoisoningtreatedsuccessfullywithkidneyreplacementtherapyandplasmapheresisacasereport AT dloverbeek severecolchicinepoisoningtreatedsuccessfullywithkidneyreplacementtherapyandplasmapheresisacasereport AT tberickson severecolchicinepoisoningtreatedsuccessfullywithkidneyreplacementtherapyandplasmapheresisacasereport AT ewboyer severecolchicinepoisoningtreatedsuccessfullywithkidneyreplacementtherapyandplasmapheresisacasereport AT cgoldfine severecolchicinepoisoningtreatedsuccessfullywithkidneyreplacementtherapyandplasmapheresisacasereport AT samuhsin severecolchicinepoisoningtreatedsuccessfullywithkidneyreplacementtherapyandplasmapheresisacasereport AT prchai severecolchicinepoisoningtreatedsuccessfullywithkidneyreplacementtherapyandplasmapheresisacasereport |