Key result
Colchicine causes fatal cardiovascular collapse at doses as low as 0.40 mg/kg.
Why the study?
Fatal outcomes after colchicine ingestion doses less than 0.5 mg/kg can occur despite existing prognostic rules predicting survival.
Case Report (n=1)
Fatal cardiovascular collapse can occur with colchicine doses less than 0.5 mg/kg, challenging previous prognostic rules that predicted 100% survival at this dose.
BACKGROUND: A previously published prognostic rule predicts 100% survival after ingestion of cochicine doses less than 0.5 mg/kg and 100% mortality after ingestion of more than 0.8 mg/kg. This rule inaccurately predicted survival in a recent case. CASE REPORT: We present a case of fatal colchicine poisoning in an adult who ingested a maximum of 39.6 mg of colchicine (0.40 mg/kg). He subsequently developed hypotension which was refractory to fluid resuscitation and infusion of vasopressors. He died of cardiovascular collapse approximately 35 hours after ingestion. DISCUSSION: Fatal outcomes are possible even with colchicine doses less than 0.5 mg/kg. Physicians caring for colchicine-poisoned patients must be prepared for the possibility of acute cardiovascular collapse and ventricular dysrhythmias regardless of the reported dose of colchicine.
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Mullins et al. (2000) conducted a case report in Acute colchicine poisoning (n=1). Acute colchicine ingestion was evaluated on Survival. Acute ingestion of 39.6 mg (0.40 mg/kg) of colchicine resulted in fatal cardiovascular collapse, demonstrating that fatal outcomes can occur at doses previously predicted to have 100% survival.
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