Progressive Organ Failure After Ingestion of Wild Garlic Juice.

BACKGROUND: Wild garlic and related plants are increasingly sought after by fans of natural products. They can be confused with other plants containing colchicine and cause potentially fatal intoxications. CASE REPORT: We report a case of accidental poisoning by Colchicum autumnale, which was mistaken for wild garlic (Allium ursinum). The patient initially presented with mild gastrointestinal symptoms, but progressed rapidly to agranulocytosis, paraparesis, and delirium before the causative agent was identified. The laboratory tests revealed rhabdomyolysis, coagulopathy, alteration of liver tests, and prerenal azotemia. Botanical examination confirmed the incriminated plant (Colchicum autumnale). Serum and urine analysis confirmed the presence of colchicine. The patient required intensive support therapy, and she fully recovered within 8 weeks. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Colchicine poisoning should be considered in the differential diagnosis of patients presenting with gastroenteritis after ingestion of wild garlic.

Plant exposures: wilderness medicine.

This article discusses poisonous plants, the symptoms that might arise if they are ingested, and the treatments that should be administered to patients.

Accidental plant poisoning with Colchicum autumnale: report of two cases.

Colchicine poisoning is a rare but serious and potentially fatal event, which results from food poisoning or overdose with drugs containing colchicine, with no currently available antidote. We report two cases of plant poisoning with Colchicum autumnale, in which the patients had identical initial symptoms but developed extremely different clinical courses. One patient recovered after only moderate gastroenteritis and liver injury, whereas the other died of rapid progressive multiple organ failure 52 h after the plant ingestion. We recommend that all patients suspected of colchicine intoxication due to its unpredictable outcome should be managed according to the principles of intensive care, irrespective of the actual degree of poisoning.

Self-poisoning with Colchicum autumnale L. flowers.

UNLABELLED: A 44-year-old man ingested about 40 flowers of Colchicum autumnale L. The patient presented with nausea, vomiting, and abdominal pain 2 hours after ingestion and had diarrhea 14 hours after ingestion. Hematological values remained within normal range. Treatment was mainly supportive. The outcome was favorable. The intoxication was confirmed by high-performance liquid chromatography-mass spectrometry. Maximal colchicine levels were 4.34 ng/mL at 13 hours in plasma and 5.43 ng/mL at 16 hours in erythrocytes. CONCLUSION: We report one of the few symptomatic cases of Colchicum autumnale L. poisoning confirmed by toxicological analysis.

Colchicine poisoning by accidental ingestion of meadow saffron (Colchicum autumnale): pathological and medicolegal aspects.

Although intoxications with colchicine, the alkaloid of Colchicum autumnale (meadow saffron), are well known, in most cases the intoxications are evoked by oral or parenteral preparations traditionally used as medication against gout. The accidental ingestion of Colchicum autumnale, on the other hand, is a rare event and has to our knowledge only twice been described in detail. We report a further case in which two persons confused this highly poisonous plant with wild garlic (Allium ursinum), a popular spice in the Central European cuisine. While one person merely complained about a 3-day episode of nausea, vomiting and watery diarrhea, the second person died of multi-organ system derangements 48 h after the ingestion of the colchicum leaves. At autopsy hemorrhagic lung oedema, hypocellular bonemarrow, centrilobular fatty necrosis of the liver and necrosis of the proximal convoluted tubuli of the kidneys were observed. A colchicine concentration of 7.5 micrograms/ml was found in the bile whereas no substance was detected in the postmortem blood.

Histopathological study of experimental acute poisoning of cattle by autumn crocus (Colchicum autumnale L.).

Crude or dehydrated bulbs of autumn crocus (Colchicum autumnale L.) were fed to eleven calves. All the calves developed severe diarrhea and died or euthanized within 63 hr. At necropsy, the gastro-intestinal mucosa was edematous and hemorrhagic. Histologically, necrosis and degeneration with karyopyknosis and karyorrhexis were shown in the basal cell layer of the tongue, esophagus, forestomach, renal pelvis, urinary bladder, neck cell layer of the abomasal gastric glands, and intestinal cryps. These findings were also seen in Kupffer cells, renal tubular epithelial cells, and lymphocytes in the lymphoid and hemopoietic systems. The lesion of the present acute crocus poisoning of cattle closely resembled those reported in humans with colchicine intoxication. Refined acetone extract of organs of poisoned cattle proved to contain colchicine and demecolcine by high performance liquid chromatography.