Clinical, Laboratory, and Electrocardiographic Findings in Colchicine Toxicity: 10 Years of Experience

Mehdi Sheibani; Nasim Zamani; Amir Hushang Gerami; Hossein Akhondi; Hossein Hassanian-Moghaddam

doi:10.3389/fmed.2022.872528

Clinical, Laboratory, and Electrocardiographic Findings in Colchicine Toxicity: 10 Years of Experience

Front Med (Lausanne). 2022 May 19:9:872528. doi: 10.3389/fmed.2022.872528. eCollection 2022.

Authors

Mehdi Sheibani¹, Nasim Zamani^{2

3}, Amir Hushang Gerami⁴, Hossein Akhondi⁵, Hossein Hassanian-Moghaddam^{2

3}

Affiliations

¹ Cardiovascular Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran.
² Department of Clinical Toxicology, Loghman-Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁴ School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran.
⁵ Department of Internal Medicine, University of Central Florida and Florida State University, Orlando, FL, United States.

Abstract

Background: We aimed to investigate the clinical, laboratory, and electrocardiographic (ECG) findings of colchicine poisoning and to evaluate if there is a correlation between them and the two major outcomes of this toxicity which are respiratory/cardiovascular failure and death.

Materials and methods: Medical records of 34 colchicine-intoxicated patients that were treated in our center during the past 10 years were retrospectively evaluated. The patient's clinical presentation, vital signs, laboratory tests, ECGs, and outcomes were reviewed.

Results: Abdominal pain, and hypotension at presentation had significant correlation with mortality (p = 0.003, OR: 2.2 [4.1, 7.9], p = 0.029, OR: 13.0 [1.5, 111.8]). Mortality significantly occurred in those with sinus tachycardia, hypokalemia, metabolic acidosis, and impaired liver and kidney function tests (p-values = 0.025, 0.007, 0.04, and 0.008, respectively). All the patients had some ECG abnormalities. Most frequent ECG abnormalities were pathologic ST segment elevation and depression (70%), left atrial enlargement (48%), and sinus tachycardia (37%), PR elevation in aVR lead (37%), and T wave inversion (37%).

Conclusions: Colchicine toxicity is a dangerous entity regarding the cardiovascular events and requires close general and cardiac monitoring.

Keywords: ECG manifestations; colchicine poisoning; colchicine toxicity; intoxication; mortality.