Early Onset Cardiogenic Shock in Acute Colchicine Overdose

Abstract

Colchicine is an alkaloid from the family of the spindle poisons. It is mainly used as treatment and prevention for gout or other forms of microcrystalline arthritis, for familial Mediterranean fever, Behçet disease and for pericarditis. It has a narrow therapeutic index and colchicine overdose is associated with high mortality rate [1]. As for the clinical course of colchicine poisoning the first phase is dominated by gastro-intestinal symptoms (0-24 hours); the second phase is characterized by multi-organ dysfunction, metabolic derangements and bone marrow suppression (1-7 days). Surviving patients will enter the third phase (7-21 days) by recovery of bone marrow depression and resolution of organ failure [2]. Death from acute colchicine poisoning is usually due to hemodynamic collapse and cardiac arrhythmias (typically 24-36 hours after ingestion) but early cardiogenic shock has not been previously reported [3,4].