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1.
J Vet Emerg Crit Care (San Antonio) ; 30(1): 74-80, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31883205

RESUMO

OBJECTIVE: To describe the treatment and clinical course of a dog accidentally prescribed 10 times the recommended dose of colchicine (0.3 mg/kg/d instead of 0.03 mg/kg/d). CASE SUMMARY: After glaucoma surgery, a 1-year-old male neutered Pomeranian weighing 6.8 kg was prescribed 1,000 µg colchicine twice a day per os. The dog presented to the emergency department after the first dose with vomiting and was treated as an outpatient. Two colchicine doses later, the dog represented with vomiting, ocular pain, and increased intraocular pressure. The dog's vital signs were normal, and the dog was admitted for rehydration, analgesia, and revision glaucoma surgery the next day. Two hours after revision surgery, the dog developed vomiting and diarrhea. Postoperatively, the dog was hypothermic (36.3°C), persistently hypertensive (227 mm Hg), and bradycardic (60/min). Biochemistry revealed metabolic acidosis and increased hepatic enzyme activities. Mannitol was administered for presumed cerebral edema. Later, the dog developed bradycardia due to second-degree atrioventricular heart block, which responded to atropine. Total hospitalization was 9 days. Treatment included IV fluids, IV lipid emulsion, N-acetylcysteine, activated charcoal, gastroprotectants, antiemetics, opioids, antimicrobials, and barrier nursing due to transient neutropenia. NEW OR UNIQUE INFORMATION PROVIDED: This is the first report to describe the successful treatment of a dog with colchicine overdose. The systemic effects were presumed to be secondary to colchicine toxicosis rather than diet, infection, or other drug reaction, and may have been compounded by a second anesthetic episode. Gastrointestinal signs, symptoms of cerebral edema, cardiac arrhythmias, and neutropenia were documented. One other report of colchicine overdose in a dog exists, and that patient was euthanized. This report demonstrates that complete recovery with intensive care is possible; however, the prognosis remains guarded.


Assuntos
Colchicina/envenenamento , Doenças do Cão/diagnóstico , Animais , Bradicardia/etiologia , Bradicardia/veterinária , Carvão Vegetal/uso terapêutico , Cuidados Críticos , Diarreia/etiologia , Diarreia/veterinária , Doenças do Cão/sangue , Doenças do Cão/terapia , Cães , Overdose de Drogas/complicações , Overdose de Drogas/veterinária , Hidratação/veterinária , Glaucoma/cirurgia , Glaucoma/veterinária , Masculino , Complicações Pós-Operatórias/veterinária , Vômito/etiologia , Vômito/veterinária
2.
Medicine (Baltimore) ; 98(30): e16580, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348292

RESUMO

RATIONALE: Colchicine can inhibit cell division and intracellular transport in affected organs by fixing intracellular tubulin and preventing its polymerization into microtubules. A lethal dose of colchicine is considered to be 0.8 mg/kg. The wide distribution of colchicine through 70% of the body following an overdose makes it difficult to eliminate. PATIENT CONCERNS: A 56-year-old man with a clear history of colchicine overdose was admitted to our hospital nearly 40 hours after taking 12 mg (0.17 mg/kg) of colchicine. He had a history of gout and chronic kidney disease. As the disease progressed, he showed most of the clinical manifestations and pathological features of colchicine overdose. DIAGNOSES AND INTERVENTIONS: Colchicine overdose was clear, with symptoms of multiple organ failure including primary gastrointestinal failure, bone marrow hematopoietic inhibition, rhabdomyolysis, cardiac damage, hepatocyte damage. The patient developed secondary septic shock, renal failure, circulatory failure, and respiratory failure. We performed continuous renal replacement therapy and gastric lavage, and administered norepinephrine, frozen plasma, proton-pump inhibitors, adenosylmethionine, antibiotics, granulocyte colony stimulating factor, and total parenteral nutrition. OUTCOMES: The patient rapidly developed complete hematopoietic function inhibition, gastrointestinal failure, and cardiac damage 32 hours after admission. Sustained severe infection and circulatory instability caused a progressive deterioration of respiratory function. Tracheal intubation was performed but the patient continued to deteriorate, and death occurred approximately 132 hours after admission. LESSONS: Excessive colchicine levels cause continuous organ damage due to extensive tissue distribution, eventually leading to multiple organ failure. Colchicine metabolism is delayed in patients with liver or kidney dysfunction, and even a low dose of colchicine may result in poisoning in these individuals. Early diagnosis and reduction of colchicine levels is critical to improve prognosis, and colchicine poisoning should be considered in patients with poor liver or kidney function even when the ingested dose is low.


Assuntos
Colchicina/envenenamento , Overdose de Drogas/fisiopatologia , Morte , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência de Múltiplos Órgãos/induzido quimicamente , Insuficiência de Múltiplos Órgãos/terapia , Terapia de Substituição Renal , Choque Séptico/induzido quimicamente , Choque Séptico/terapia
3.
BMJ Case Rep ; 12(5)2019 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-31101749

RESUMO

Gloriosa superba is an ornamental herb, wildly found in the tropics especially in the southern parts of India and Sri Lanka. All parts of the plants are toxic, especially the tuberous rhizomes in view of their high content of colchicines and its derivatives. We report a case of fatal ingestion of the tubers of G. superba, with an intention of deliberate self harm, leading to systemic coagulopathy and progressive multiple organ dysfunctions. The patient was managed with intralipid rescue therapy, plasmapheresis, haemodialysis and intensive care. The ease of availability makes plant poisons, a common method of deliberate self-harm in South India. This report reiterates the need for clinician's awareness of common toxidromes associated with plant poisons.


Assuntos
Colchicina/envenenamento , Tubérculos/envenenamento , Adolescente , Evolução Fatal , Feminino , Humanos , Insuficiência de Múltiplos Órgãos/etiologia
4.
Int J Legal Med ; 133(4): 1065-1073, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31028469

RESUMO

The plant species Gloriosa superba and Colchicum autumnale produce extremely poisonous colchicine as a major toxic metabolite. Almost all previous studies on colchicine poisoning have focused on drug analysis and clinical and pathological aspects. In this study, we developed a rapid, highly sensitive method to identify G. superba and C. autumnale. This method, which can distinguish between G. superba and C. autumnale using even minute amounts of plant material, is based on duplex real-time PCR in combination with melting curve analysis. To discriminate between the two genera of colchicine-containing plants, we designed new primer pairs targeting the region of the ycf15 gene, which is present in C. autumnale but not G. superba. By producing PCR amplicons with easily distinguishable melting temperatures, we were able to rapidly and accurately distinguish G. superba from C. autumnale. The new primer pairs generated no PCR amplicons from commercially available human DNA or various plant DNAs except for G. superba and C. autumnale. Sensitivity testing indicated that this assay can accurately detect less than 0.031 ng of DNA. Using our method in conjunction with colchicine drug analysis, we successfully identified G. superba in the stomach contents of a suicide victim who ingested massive quantities of a colchicine-containing plant. According to these results, duplex real-time PCR analysis is very appropriate for testing forensic samples, such as stomach contents harboring a variety of vegetables, and enables discrimination between G. superba and C. autumnale in forensic and emergency medical fields.


Assuntos
Colchicina/envenenamento , Overdose de Drogas/diagnóstico , Plantas Tóxicas/envenenamento , Suicídio , Humanos , Reação em Cadeia da Polimerase em Tempo Real/métodos
5.
Leg Med (Tokyo) ; 38: 64-68, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30991227

RESUMO

Although fatal colchicine intoxications are rare and mostly related to suicidal intake or accidental overdose, other hypotheses should be considered when dealing with colchicine poisoning. We present a case of double, acute, and subacute, fatal colchicine intoxication in a married couple. The 70-year-old male victim suddenly died after vomiting and diarrhea. The next day his wife showed aggravating gastrointestinal symptoms and was hospitalized with a diagnosis of septic shock. A complete postmortem examination on the man was performed, together with histopathological analysis. Toxicological examination performed through liquid chromatography coupled to mass spectrometry revealed a colchicine blood peripheral concentration of 33 ng/mL. A few days after hospitalization, the woman showed a colchicine plasma concentration of 32 ng/mL. Despite veno-venous hemofiltration, she ultimately died of septic shock and multi-organ failure. Death scene investigation revealed that, a few days before the death of the male victim, the couple had collected wild saffron and had eaten a presumed saffron risotto. The integrated analysis of circumstantial, clinical, postmortem and toxicological data allowed to establish that the couple had died of a fatal accidental intoxication due to the ingestion of natural colchicine, mistaken for saffron. The death of the male was deemed caused by acute cardiovascular collapse induced by acute intoxication, while the female had suffered a subacute poisoning by antimitotic agent, resulting in immunosuppression and systemic infection. Toxicological analyses, promptly performed on the man for forensic purposes, directed the investigations and suggested the clinical diagnosis on the woman.


Assuntos
Antimitóticos/envenenamento , Colchicina/envenenamento , Crocus , Medicina Legal , Insuficiência de Múltiplos Órgãos/etiologia , Insuficiência de Múltiplos Órgãos/patologia , Choque Séptico/etiologia , Choque Séptico/patologia , Choque/etiologia , Choque/patologia , Acidentes , Doença Aguda , Idoso , Autopsia , Colchicina/sangue , Evolução Fatal , Feminino , Humanos , Masculino , Cônjuges
6.
Pediatr Emerg Care ; 35(5): e96-e97, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-28486264

RESUMO

Seizure is the most common presentation of neurological disorder in the pediatric emergency care setting. In evaluating the child after a first seizure, the first consideration should be determining if the seizure was provoked or unprovoked. Investigation listing the causes of the first seizure is considerably long, and adverse drug reactions must be in mind. Epileptic seizures after using thiocolchicoside (TCC) have been reported in several adult patients with epilepsy and acute brain injury. We present a previously healthy 3-month-old female infant who was admitted to the emergency department with a generalized seizure after exposure to TCC. To the best of our knowledge, this is the first case of a child who had an epileptic seizure after TCC intake via breastfeeding in the literature.


Assuntos
Colchicina/análogos & derivados , Convulsões/induzido quimicamente , Aleitamento Materno , Colchicina/envenenamento , Feminino , Humanos , Lactente
7.
J Forensic Sci ; 64(4): 1274-1280, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30536549

RESUMO

A case of suspected acute and lethal intoxication caused by colchicine has been reported. The woman was hospitalized after her suspicion of suicidal poisoning by a rare autumn crocus (Colchicum autumnale). Suspected colchicine poisoning was confirmed using a novel UHPLC method with a modern reversed-phase stationary phase with a sub 2-micron superficial porous particle size combined with a QTOF mass spectrometer. Sample preparation procedure included the addition of propiverine as internal standard, protein precipitation using methanol and solid phase extraction. High-resolution MS only and targeted MS/MS modes are reported for the qualitative analysis and screening of other potential drugs of abuse in blood samples. All Ion MS mode was used for quantitative determination of colchicine afterward. The concentration of colchicine in the blood sample was approximately 41 ng/mL, and more than 200 µg/mL of the plant extract used for the suicide.


Assuntos
Colchicina/envenenamento , Espectrometria de Massas/métodos , Suicídio , Cromatografia Líquida de Alta Pressão , Colchicina/sangue , Colchicum , Feminino , Humanos , Pessoa de Meia-Idade , Extratos Vegetais/envenenamento
8.
BMC Pharmacol Toxicol ; 19(1): 69, 2018 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-30376897

RESUMO

BACKGROUND: Colchicine is a natural alkaloid that is mainly used for the treatment of inflammatory diseases. Effective and toxic doses are very similar, but case reports of higher colchicine doses inducing acute toxicosis is rare. CASE PRESENTATION: A 19-year-old woman was sent to the emergency room for taking 80 colchicine tablets (0.5 mg per tablet) 44 h previously. The main physical symptom was abdominal pain. Following ingestion, the patient suffered multi-system failure including renal, respiratory, circulatory, and digestive. Continuous renal replacement therapy (CRRT) and other treatment measures were used to remove metabolic wastes and poisons, and to treat other complications. Renal function was restored after a series of treatments. CONCLUSION: We report a case of an acute kidney injury induced by an overdose of colchicine. CRRT and a series of related treatments were beneficial for the treatment of colchicine poisoning.


Assuntos
Lesão Renal Aguda/induzido quimicamente , Colchicina/envenenamento , Dor Abdominal/induzido quimicamente , Dor Abdominal/terapia , Lesão Renal Aguda/terapia , Adulto , Overdose de Drogas , Feminino , Humanos , Terapia de Substituição Renal , Tentativa de Suicídio , Adulto Jovem
9.
J Med Case Rep ; 12(1): 191, 2018 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-29970148

RESUMO

BACKGROUND: Although 0.8 mg/kg is considered a lethal dose of colchicine, fatal cases of patients who followed a critical disease course after an intake below this lethal dose have been reported. CASE PRESENTATION: An 18-year-old Japanese woman who had taken an overdose of prescription colchicine (15 mg; 0.2 mg/kg) was brought to our emergency out-patient department. Although her colchicine intake was below 0.8 mg/kg (considered the lethal dose), she reached a critical state and underwent three phases characterizing colchicine poisoning (gastrointestinal symptoms, multiple organ failure, and recovery). Her condition was critical, with a Sequential Organ Failure Assessment score of a maximum of 14. CONCLUSIONS: Patients might reach a critical stage after colchicine ingestion at a non-lethal dose. Thus, it might be necessary to review which dose of colchicine should be considered lethal.


Assuntos
Dor Abdominal/tratamento farmacológico , Colchicina/envenenamento , Overdose de Drogas/terapia , Insuficiência de Múltiplos Órgãos/induzido quimicamente , Moduladores de Tubulina/envenenamento , Dor Abdominal/etiologia , Adolescente , Animais , Síndrome de Behçet/complicações , Estado Terminal/terapia , Feminino , Humanos , Insuficiência de Múltiplos Órgãos/terapia , Coelhos
10.
Pediatr Emerg Care ; 34(7): e131-e133, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29912088

RESUMO

Colchicine is an anti-inflammatory drug that has a narrow therapeutic index. Poisoning typically shows 3 phases with systemic symptoms. Gastrointestinal symptoms dominate in the first phase. Dermatologic manifestations usually appear, with skin eruptions in the second phase where multiorgan failure occurs and alopecia in the third phase where organ derangements resolve. Alopecia is a cardinal feature of the third phase, but there is no specifically defined eruption for toxication. Here, we report a case of colchicine intoxication in a 16-year-old girl with maculopapular/purpuric rash and alopecia.


Assuntos
Colchicina/envenenamento , Dermatopatias/induzido quimicamente , Moduladores de Tubulina/envenenamento , Adolescente , Feminino , Humanos , Pele/patologia
11.
J Emerg Med ; 55(3): e65-e69, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29685473

RESUMO

BACKGROUND: Colchicine ingestion is rare but highly lethal. Patients usually die of multiorgan failure and cardiogenic shock. Colchicine is not only associated with depressed myocardial function but also with fatal heart rhythm disturbances, such as complete heart block, ventricular tachycardia, and asystole. While histologic changes of myocytes are well known, the mechanism by which colchicine affects cardiac impulse generation and conduction is not fully understood. CASE REPORT: We present a case of colchicine ingestion with sinus bradycardia, marked sinus arrhythmia, and first- and second-degree heart block. A 10-year-old previously healthy boy was brought to the emergency department for the sudden onset of dizziness, abdominal pain, and vomiting after ingesting his grandfather's colchicine and furosemide. His symptoms improved with ondansetron and intravenous normal saline. However, because of the colchicine ingestion, he was admitted to the pediatric intensive care unit for observation. He first developed PR prolongation (∼4-30 h postingestion) followed by marked sinus bradycardia and sinus arrhythmia along with second-degree heart block (∼48-60 hours postingestion). The minimum heart rate was 40 beats/min. Marked sinus arrhythmia was observed, suggesting an increase in parasympathetic activity. His heart rhythm improved initially with less sinus arrhythmia followed by resolution of heart block. He was discharged home without any sequelae. Holter monitoring 1 week after discharge showed normal heart rate variability for age. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case provides novel insights into how colchicine may affect the heart's electrophysiology. Colchicine may increase the parasympathetic tone enough to cause sinus bradycardia and different degrees of heart block.


Assuntos
Arritmia Sinusal/induzido quimicamente , Bloqueio Atrioventricular/induzido quimicamente , Bradicardia/induzido quimicamente , Colchicina/envenenamento , Supressores da Gota/envenenamento , Criança , Diagnóstico Diferencial , Eletrocardiografia , Humanos , Masculino
12.
Clin Toxicol (Phila) ; 56(8): 773-781, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29334816

RESUMO

BACKGROUND: Colchicine poisoning is commonly lethal. Colchicine-specific Fab fragments increase rat urinary colchicine clearance and have been associated with a good outcome in one patient. We aimed to develop a porcine model of colchicine toxicity to study the pharmacokinetics and efficacy of ovine Fab. METHODS: A Göttingen minipig critical care model was established and serial blood samples taken for colchicine and Fab pharmacokinetics, clinical chemistry, and haematology. Animals were euthanised when the mean arterial pressure fell below 45 mmHg without response to vasopressor, or at study completion. RESULTS: Initial studies indicated that oral dosing produced variable pharmacokinetics and time-to-euthanasia. By contrast, intravenous infusion of 0.25 mg/kg colchicine over 1 h produced reproducible pharmacokinetics (AUC0-20 343 [SD = 21] µg/L/h), acute multi-organ injury, and cardiotoxicity requiring euthanasia a mean of 22.5 (SD = 3.2) h after dosing. A full-neutralising equimolar Fab dose given 6 h after the infusion (50% first hour, 50% next 6 h [to reduce renal-loss of unbound Fab]) produced a 7.35-fold increase in plasma colchicine (AUC0-20 2,522 [SD = 14] µg/L/h), and removed all free plasma colchicine, but did not prevent toxicity (euthanasia at 29.1 [SD = 3.4] h). Earlier administration over 1 h of the full-neutralising dose, 1 or 3 h after the colchicine, produced a 12.9-fold (AUC0-20 4,433 [SD = 607] µg/L/h) and 6.0-fold (AUC0-20 2,047 [SD = 51] µg/L/h) increase in plasma colchicine, respectively, absence of free plasma colchicine until 20 h, and survival to study end without marked cardiotoxicity. CONCLUSIONS: Colchicine-specific Fab given early, in equimolar dose, bound colchicine, eliciting its movement into the blood, and preventing severe toxicity. Clinical studies are now needed to determine how soon this antidote must be given to work in human poisoning.


Assuntos
Antídotos/farmacologia , Antídotos/uso terapêutico , Colchicina/sangue , Colchicina/envenenamento , Fragmentos Fab das Imunoglobulinas/farmacologia , Fragmentos Fab das Imunoglobulinas/uso terapêutico , Administração Intravenosa , Administração Oral , Animais , Fragmentos Fab das Imunoglobulinas/sangue , Modelos Animais , Suínos , Porco Miniatura
13.
Drug Des Devel Ther ; 11: 3321-3324, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29200827

RESUMO

Colchicine overdose is uncommon but potentially life threatening. Due to its serious adverse systemic effects, overdose must be recognized and treated. We report a case of an 18-year-old female who ingested 18 mg (~0.4 mg/kg) of colchicine in a suicide attempt. The patient's clinical manifestations included abdominal cramps, vomiting, pancytopenia, hypocholesterolemia, and rhabdomyolysis. Two unique manifestations of toxicity in this patient were profound and persistent, severe hypertriglyceridemia and electrolyte imbalance, mainly hypophosphatemia, with no other evident cause except the colchicine intoxication. Following intensive supportive treatment, including ventilator support, N-acetylcysteine, granulocyte colony stimulating factor, electrolyte repletion, and zinc supplementation, the patient made a complete recovery. Colchicine intoxication is a severe, life-threatening situation that should be followed closely in intensive care units. Severe changes in body functions can rapidly develop, as previously described in the literature. To our knowledge, this extremely elevated triglyceride level has never been reported without the administration of propofol, and requires further evaluation.


Assuntos
Colchicina/envenenamento , Hipertrigliceridemia/induzido quimicamente , Tentativa de Suicídio , Adolescente , Colchicina/administração & dosagem , Feminino , Humanos , Hipertrigliceridemia/tratamento farmacológico , Índice de Gravidade de Doença
15.
Clin Toxicol (Phila) ; 55(8): 914-918, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28535126

RESUMO

BACKGROUND: Poisoning with Gloriosa superba, a plant containing colchicine, is common in Sri Lanka. OBJECTIVES: This study was to estimate release of colchicine from 5 g of different parts of Gloriosa superba in simulated gastric and intestinal media, and examine the binding efficacy of activated charcoal (AC) to colchicine within this model. METHODS: A USP dissolution apparatus-II was used to prepare samples for analysis of colchicine using HPLC. RESULTS: Cumulative colchicine release from tuber in gastric media at 120 minutes was significantly higher (2883 µg/g) than in intestinal media (1015 µg/g) (p < .001). Mean ± SD cumulative colchicine concentration over 2 hours from tuber, leaves and trunk in gastric medium was 2883.15 ± 1295.63, 578.25 ± 366.26 and 345.60 ± 200.08 µg/g respectively and the release in intestinal media was 1014.75 ± 268.16, 347.40 ± 262.61 and 251.55 ± 285.72 µg/g respectively. Introduction of 50 g of AC into both media made colchicine undetectable (<0.1 µg/ml). CONCLUSIONS: The tuber released the highest quantity of colchicine. The colchicine release and elapse time to achieve saturated, equilibrium dissolution mainly depends on physicochemical properties of plant part. Significant in vitro binding of colchicine to AC suggests that AC has a role in decontamination of patients presenting to hospital after ingestion of Gloriosa superba.


Assuntos
Antídotos/farmacologia , Carvão Vegetal/farmacologia , Colchicina/envenenamento , Suco Gástrico/química , Secreções Intestinais/química , Liliaceae/envenenamento , Intoxicação por Plantas/tratamento farmacológico , Colchicina/química , Liberação Controlada de Fármacos , Concentração de Íons de Hidrogênio , Cinética , Liliaceae/química , Folhas de Planta/química , Folhas de Planta/envenenamento , Intoxicação por Plantas/etiologia , Caules de Planta/química , Caules de Planta/envenenamento , Tubérculos/química , Tubérculos/envenenamento , Solubilidade
17.
J Emerg Med ; 52(4): 499-503, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27727039

RESUMO

BACKGROUND: Colchicine poisoning is an uncommon but serious form of drug intoxication. It may produce life-threatening systemic effects. In toxic doses it produces nausea and vomiting and bone marrow suppression, often leading to sepsis, hypocalcemia, adult respiratory distress syndrome, and direct cardiotoxic effects. OBJECTIVE: The aim of this study was to describe demographic features and the outcome of patients poisoned with colchicine. METHODS: A retrospective study of the pediatric intensive care unit database was performed for patients ≤18 years of age who had colchicine poisoning between July 2008 and July 2013. RESULTS: The total number of patients with drug poisoning in the study period was 144. Nine of 144 were related to colchicine poisoning. The median age was 4 years (range 20 months to 16 years) and the number of females was five. Six of the nine cases presented after ingesting <0.5 mg/kg, whereas two patients had consumed 0.5 to 0.8 mg/kg. One patient had received colchicine >0.8 mg/kg. Three patients died. CONCLUSIONS: Among drug intoxications, colchicines can lead to severe clinical conditions. All patients suspected of having colchicine intoxication should be managed in the pediatric intensive care unit regardless of the actual degree of poisoning.


Assuntos
Colchicina/farmacocinética , Colchicina/envenenamento , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/terapia , Adolescente , Doenças da Medula Óssea/etiologia , Criança , Pré-Escolar , Colchicum/efeitos adversos , Coagulação Intravascular Disseminada/etiologia , Feminino , Humanos , Hipocalcemia/etiologia , Lactente , Unidades de Terapia Intensiva Pediátrica/organização & administração , Leucocitose/complicações , Leucocitose/etiologia , Linfo-Histiocitose Hemofagocítica/complicações , Linfo-Histiocitose Hemofagocítica/etiologia , Masculino , Náusea/etiologia , Troca Plasmática/métodos , Terapia de Substituição Renal/métodos , Síndrome do Desconforto Respiratório do Adulto/etiologia , Estudos Retrospectivos , Sepse/etiologia , Choque/etiologia , Vômito/etiologia
20.
BMC Pharmacol Toxicol ; 17(1): 26, 2016 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-27324655

RESUMO

BACKGROUND: Gloriosa superba, well known as the glory lily or superb lily, is a tropical climbing plant that features an exotic red flower. The plant is poisonous because of high concentrations of colchicine in all parts of the plant. It is commercially grown for use in Ayurveda medicine and as a cash crop for extracting colchicine in India and Africa. It is a wild plant in Sri Lanka and commercial cultivation is rare. Accidental and suicidal poisonings with Gloriosa tubers are well known and reported. There are no case reports of poisoning by Gloriosa seeds in Sri Lanka. Google and PubMed searches showed no reported cases of poisoning with seeds or their use with homicidal intent in other parts of the world. CASE PRESENTATION: A 27-year-old man was brought to hospital with profuse vomiting and diarrhea after drinking coriander tea, which is a common traditional treatment for common cold. The family members suspected poisoning by Gloriosa because they had seeds at home and the victim's sister-in-law who had made the herbal tea went missing from home. They were able to identify Gloriosa seeds, which looked similar to coriander, in the pot. The patient developed shock and respiratory distress and needed ventilation and intensive care. He also developed mild renal impairment, and thrombocytopenia. He developed massive generalized alopecia while recovering from acute illness. Full recovery was achieved after 15 days of hospital care. CONCLUSIONS: There are many poisonous plants in Asian countries. This case highlights the possibility of accidental or intentional use of Gloriosa seeds or its extracts to cause potentially fatal poisoning. It would be difficult to identify Gloriosa as the cause of poisoning without any background information because of multiple complications that can mimic a systemic infection. This case is a good example of the use of plants as biological weapons.


Assuntos
Colchicina/envenenamento , Homicídio , Liliaceae/envenenamento , Sementes/envenenamento , Adulto , Gastroenteropatias/induzido quimicamente , Gastroenteropatias/diagnóstico , Humanos , Masculino , Chá/envenenamento , Vômito/induzido quimicamente , Vômito/diagnóstico
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