Chronic Human Colchicine Myopathy and Neuropathy

To the Editor. —The first case of human colchicine myopathy was reported by Kontos¹in 1962. The case was somewhat misleading since the disorder occurred at an unusually high "nonpharmacologic" dose of colchicine; the syndrome was unsubstantiated histopathologically since muscle biopsy results were said to be normal. Later, the morphology of a colchicine-induced myopathy in laboratory animals was well described.²The recent case of colchicine neuro-muscular disease reported by Riggs et al³was valuable in being the first report to document the human intoxication histopathologically. The authors described central architectural and vacuolar changes of skeletal muscle fibers, and showed the coexistent axonal degeneration. However, this second case was also unusual. First, the disorder was the result of multiple acute intoxications because of a bizarre self-dosing schedule. Second, the electromyogram showed only signs of axonal neuropathy and denervation. Third, the serum creatine kinase level remained mildly elevated