Colchicine poisoning

What it is

From: Orphanet

Colchicine poisoning is a potentially life-threatening poisoning, due to ingestion of the drug or consumption of the plant Colchicum autumnale, that usually begins with gastrointestinal symptoms (e.g. abdominal pain, nausea, vomiting, and diarrhea, that cause severe dehydration) and an initial leukocytosis leading to marrow failure (24 hours after ingestion), followed by potentially fatal multi-organ failure with mental status change, oliguric renal failure, disseminated intravascular coagulation, electrolyte imbalance, acid-base disturbance, cardiac failure/arrest and shock within 1-3 days.

Reported clinical features and what the terms mean

The following findings are associated with this condition in Orphanet. They are not a checklist for diagnosing yourself, and they do not all occur in every affected person. Some are examination, imaging or laboratory findings that cannot be recognised at home.

The frequency labels describe how often a finding was reported among people with the condition in the source. They do not give the chance that a person with that symptom has the condition. Definitions below reproduce HPO terminology; they explain the term, not the likely severity in an individual.

Hypotension · Very frequent (99-80%)

Low Blood Pressure, vascular hypotension.

Increased total leukocyte count · Very frequent (99-80%)

An abnormal increase in the number of leukocytes in the blood.

Metabolic acidosis · Very frequent (99-80%)

Metabolic acidosis (MA) is characterized by a fall in blood pH due to a reduction of serum bicarbonate concentration. This can occur as a result of either the accumulation of acids (high anion gap MA) or the loss of bicarbonate from the gastrointestinal tract or the kidney (hyperchloremic MA). By definition, MA is not due to a respirary cause.

Nausea · Very frequent (99-80%)

A sensation of unease in the stomach together with an urge to vomit.

Respiratory distress · Very frequent (99-80%)

Respiratory distress is objectively observable as the physical or emotional consequences from the experience of dyspnea. The physical presentation of respiratory distress is generally referred to as labored breathing, while the sensation of respiratory distress is called shortness of breath or dyspnea.

Vomiting · Very frequent (99-80%)

Forceful ejection of the contents of the stomach through the mouth by means of a series of involuntary spasmic contractions.

Dehydration · Very frequent (99-80%)

Abnormal blood ion concentration · Frequent (79-30%)

Abnormality of the homeostasis (concentration) of a monoatomic ion.

Abnormality of acid-base homeostasis · Frequent (79-30%)

An abnormality of the balance or maintenance of the balance of acids and bases in bodily fluids, resulting in an abnormal pH.

Abnormality of blood and blood-forming tissues · Frequent (79-30%)

An abnormality of the hematopoietic system.

Arrhythmia · Frequent (79-30%)

Any cardiac rhythm other than the normal sinus rhythm. Such a rhythm may be either of sinus or ectopic origin and either regular or irregular. An arrhythmia may be due to a disturbance in impulse formation or conduction or both.

Cardiogenic shock · Frequent (79-30%)

Severely decreased cardiac output with evidence of inadequate end-organ perfusion (i.e., tissue hypoxia) in the presence of adequate intravascular volume.

Congestive heart failure · Frequent (79-30%)

The presence of an abnormality of cardiac function that is responsible for the failure of the heart to pump blood at a rate that is commensurate with the needs of the tissues or a state in which abnormally elevated filling pressures are required for the heart to do so. Heart failure is frequently related to a defect in myocardial contraction.

Diarrhea · Frequent (79-30%)

Abnormally increased frequency (usually defined as three or more) loose or watery bowel movements a day.

Other findings in the same source

From: Orphanet

Additional reported features include Disseminated intravascular coagulation (Frequent (79-30%)); Hypocalcemia (Frequent (79-30%)); Hypokalemia (Frequent (79-30%)); Hypomagnesemia (Frequent (79-30%)); Hyponatremia (Frequent (79-30%)); Hypophosphatemia (Frequent (79-30%)); Hypovolemia (Frequent (79-30%)); Lactic acidosis (Frequent (79-30%)); Myocarditis (Frequent (79-30%)); Oliguria (Frequent (79-30%)). This is a selected summary, not a complete description of the condition.

When it may begin

From: Orphanet

All ages

Inheritance in the source

From: Orphanet

Not applicable

Frequency and the population described

From: Orphanet

Point prevalence: 1-9 / 1 000 000; Europe; Value and class.

Which doctor should you see?

The suggested department for discussing Colchicine poisoning is Emergency Medicine, with a emergency physician as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• What is the immediate problem that needs stabilisation?
• Which results and discharge instructions should the family keep?
• What follow-up and return precautions are needed after emergency treatment?

Treatment discussions and follow-up

The material gathered for this draft does not provide a complete condition-specific treatment pathway for Colchicine poisoning. That gap does not mean that treatment is unavailable. A clinician needs to establish the diagnosis and review current guidance before recommending medicines, procedures, rehabilitation or other support.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.