Colchicine et intoxication pédiatrique: À propos d'un décès accidentel et revue de la littérature

Abstract

Colchicine, an active alkaloid from the plant Colchicum, is used to treat gout and other inflammatory diseases such as familial Mediterranean fever. There is also evidence that colchicine may prove to be a useful adjunct to current therapy in the treatment of pericarditis. The authors present the death of a 4-year-old child, weighing 16kg, who was administered for 2 consecutive days 8mg of colchicine. There was a mistake in the dosage, introducing a confusion between 0.5mg/day and 0.5mg/kg/day. The toxicity of colchicine was increased by the concurrent prescription of azithromycin, a macrolide type antibiotic. After diarrheas and vomiting, the child collapsed with multiple visceral fatal failures. Tested by LC/MS-MS, the concentration of colchicine in peripheral blood was 14.7 ng/mL, with no apparent drug redistribution, as the cardiac blood was tested at 11.8 ng/mL. A high concentration was found in bile that tested positive at 348 ng/mL. Negative hair analysis documented the naïve status of the child. A literature review has confirmed the un-frequent colchicine fatal poisonings in pediatric population in comparison with adults, irrespective of the manner of death, accidental, suicide or homicide.