Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2021; 9(35): 11050-11055
Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.11050
Chronic colchicine poisoning with neuromyopathy, gastric ulcers and myelosuppression in a gout patient: A case report
Meng-Mei Li, Jun Teng, Yan Wang
Meng-Mei Li, Jun Teng, Yan Wang, Department of Emergency, Qingdao Central Hospital, The Second Affiliated Hospital of Qingdao University Medical College, Qingdao 266042, Shandong Province, China
Author contributions: Li MM and Teng J were the patient’s attending physicians, reviewed the literature and contributed to manuscript drafting; Wang Y was responsible for revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Teng, MD, Chief Doctor, Department of Emergency, Qingdao Central Hospital, The Second Affiliated Hospital of Qingdao University Medical College, No. 127 Siliu South Road, Qingdao 266042, Shandong Province, China. owen-145@163.com
Received: June 9, 2021
Peer-review started: June 9, 2021
First decision: July 15, 2021
Revised: July 26, 2021
Accepted: October 27, 2021
Article in press: October 27, 2021
Published online: December 16, 2021
Processing time: 183 Days and 20.8 Hours
Abstract
BACKGROUND

Colchicine has been widely used as an anti-gout medication over the past decades. However, it is less commonly used due to its narrow therapeutic range, meaning that its lethal dose is close to its therapeutic dose. The lethal dose of colchicine is considered to be 0.8 mg/kg. As chronic colchicine poisoning has multiple manifestations, it poses a challenge in the clinician’s differential diagnosis. Historically, the drug was important in treating gout; however, clinical studies are currently underway regarding the use of colchicine in patients with coronavirus disease 2019 as well as its use in coronary artery disease, making this drug more important in clinical practice.

CASE SUMMARY

A 61-year-old male with a history of gout and chronic colchicine intake was admitted to our Emergency Department due to numbness and weakness of the lower limbs. The patient reported a history of colchicine intake for 23 years. After thorough examination, he was diagnosed with colchicine poisoning, manifesting as neuromyopathy, multiple gastric ulcers and myelosuppression. We advised him to stop taking colchicine and drinking alcohol. We also provided a prescription of lansoprazole and mecobalamin, and then asked him to return to the clinic for re-examination. The patient was followed up for 3-mo during which time his gout symptoms were controlled to the point where he was asymptomatic.

CONCLUSION

Colchicine overdose can mimic the clinical manifestations of several conditions. Physicians easily pay attention to the disease while ignoring the cause of the disease. Thus, the patient’s medication history should never be ignored.

Keywords: Colchicine poisoning; Neuromyopathy; Myelosuppression; Gastric ulcer; Gout; Case report

Core Tip: With ongoing clinical trials on colchicine use in more generalized diseases, the probability of chronic colchicine poisoning is on the rise. Chronic colchicine poisoning has multiple manifestations. In this case, it presented with neuromyopathy, multiple gastric ulcers and myelosuppression, demonstrating its clinical significance.