- 1
- From the Council of Forensic Medicine, Istanbul, Turkey.
Abstract
Colchicine is derived from Colchicum autumnale
and Gloriosa superba and is used to treat acute gout and familial
Mediterranean fever (FMF). Musculoskeletal adverse effects range from
myopathy to rhabdomyolysis. An 18-year-old woman, with a 2-year history
of FMF treated with colchicine, took 9 colchicine pills (4.5 mg) to
relieve severe abdominal pain. On the sixth day of hospitalization, the
patient's condition worsened, and she died. As this was a case of fatal
poisoning, a forensic autopsy was performed, and the cause of death was
determined to be complications of muscle destruction due to colchicine
intoxication with the findings of myocytolysis, positive antimyoglobin
antibody staining kidney tubules. Colchicine toxicity begins with
gastrointestinal symptoms. Multiorgan effects follow the
gastrointestinal effects. Serious outcomes of colchicine toxicity are
rhabdomyolysis, bone marrow suppression, and disseminated intravascular
coagulation. In chronic diseases that require lifelong treatment with
medications, adverse effects can arise with long periods of use. Our
patient had been treated for FMF with colchicine for 2 years but took
too many colchicine pills to relieve her severe abdominal pain. Warning
patients about the effects of high doses of drugs and providing
information about their toxic effects and what to do "in case" of
overuse could be lifesaving.
