Citation

Pérez Marín M, Prod'hom S, de Villiers SF, Ferry T, Amiet V, Natterer J, Perez MH, Buclin T, Chtioui H, Longchamp D. Front. Pediatr. 2021; 9: e658347.

Copyright

(Copyright © 2021, Frontiers Media)

DOI

10.3389/fped.2021.658347

PMID

33898365

Abstract

Colchicine poisoning is associated with a poor prognosis, especially when leading to shock and multi-organ failure, and management is limited to supportive care, including multiple-dose activated charcoal. At therapeutic concentrations, colchicine elimination occurs mainly through hepatic metabolism and involves an enterohepatic circulation, with a small contribution of renal elimination (10-30%). Colchicine toxicokinetics is however rarely described, especially in children. We present the case of a 4-year-old patient who survived a severe iatrogenic colchicine intoxication with a dose of 0.5 mg/kg. She developed multi-organ failure and shock, but recovered after receiving aggressive resuscitation, including extracorporeal life support. Close monitoring of colchicine blood levels showed a plateau for 6 days, indicating impeded elimination resulting from liver failure. We observed no significant clearance from renal replacement therapy, nor activated charcoal, during this period. Extracorporeal life support may play a supportive role in the management of severe colchicine poisoning. However, extracorporeal techniques do not seem to improve colchicine elimination.

Language: en

Keywords

pediatric; case report; colchicine poisoning; ECMO; toxicokinetics